What It Is & How to Stop It with 9 Magic Home Remedies
A 48 Minute Instructional Audio Recording
Why Premature Ejaculation is a Serious Problem...and how this course came to be.
Why Curing Premature Ejaculation Requires Going Against Nature and Into Art
The Magic 9...
1. Oxygen Power
2. The Secret 30-Second Trick. Using the Rocking Technique to Increase Orgasm Power.
3. Making it to the Safe Zone
4. Positions of Power and Control. Avoiding Angles that Damage the Penis.
5. Interruption for Continuous Pleasure. Penis Exercises for Learning Extended Intercourse.
6. Toys for Pleasure and Endurance
7. Listening to the Music and Anticipating a New Creation. Going to Your Favorite Class.
8. Easy Mind Control Techniques for Switching On and Off. Meditation.
9. Other Techniques: The PC Muscle, Squeeze Technique, Ejaculation Before Sex, Creams, Condom With the One You Trust.
Alcohol Before Your Appearance at Carnegie Hall?
Putting it All Together to Make Music.
Then Forget Everything and Just Love.
Sex for Worship and Connection.
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Dr. Runels Explains How Walking Can Improve Your Penis & Your Life
Since sex can ask for the heart about as much as walking up stairs, man is good in bed for about as long as he can comfortably walk up stairs. Is that enough to encourage you to think about walking?
Ask your physician before following any advice on this podcast...
Let's talk about walking. Now, why is walking so important and other forms of aerobic exercise are important, but why do I prefer walking over those other forms of exercise? I'm a big fan of swimming. The problem with swimming is that it requires a swimming pool. If you don't have an indoor pool, then the weather must be proper and it's expensive to maintain this. Usually if you're using a YMCA pool or something like that, access to the pool is a problem.
The problem with biking is that it's been shown that long-term use of the bicycle seat can cause erection problems because you're sitting on the pudendal nerve. You can have numbness and it can cause erectile dysfunction. It's not just one study but multiple studies showing this to be a risk. Of course you could have a properly seated or fitted bicycle seat that might help with that but, again, you're also limited to you need your gear and there's some risk involved with actually being on the street. It seems like there's a person killed about every third year in the town where I live where there's a lot of biking that goes on. I used to do triathlons. The culture of the triathlon crowd was that it wasn't if you're going to crash, it's when you crash your bike, how badly would you be injured? It's just a part of the risk that you have from using a bicycle everyday.
Part of the reasons that I prefer walking over other aerobic exercises is that it's safe. You don't need much gear. You can do it anywhere and it seems to be very, very, very effective. Now, walking does much more than just "increase your circulation." It's the best. It's probably the best, at least in the top three best habits that I could tell you to do. Here I mean this is a keystone, cornerstone habit. For example, what do I mean by cornerstone habit? Let's say that I tell you it's a good thing to have an apple a day. Well, one apple a day is a good thing. It's an appetite suppressant for more caloric, calorie-dense foods that may not be so helpful. An apple has some nutrients that are useful to you.
But one apple a day does nothing, relatively nothing, in comparison to walking a certain number of miles per day, which we'll get to. Walking does so many other things because it changes other things in your secondarily. So, for example, keystone bad habits might be smoking. Smoking does so many harmful things that it's really a cornerstone bad habit. So this is the thing that I see most consistently. It's the thing that I see most consistently in men who function sexually into their eighties with normal sexual function without any medications, and it's the thing that I see most consistently in people who just maintain clear thinking and productivity and excellent health into their seventies and eighties. And of course, it's not just about maintaining this excellent health into your eighties, it's the fact that this same cornerstone habit gives you improved health in your forties and fifties.
I'm a big fan of George Sheehan, who wrote prolifically. He's a cardiologist who wrote prolifically for Runner's World when other cardiologists were saying that walking and jogging would create this athletic left ventricle hypertrophy, and it was a bad thing to do. And now we know of course that is not true, and that walking is a very good thing to do. We'll get to why that is so very shortly. But George Sheehan always said "You know, even if walking or jogging does not improve or extend the length of my life, being out on the street everyday, doing the miles improves the quality of my life today."
You know, one of the ways I like to think about health is what I call the Titanic philosophy. If you're on the Titanic would this be a habit that you would do everyday while you're on the Titanic? Suddenly you wake up, you're on the Titanic and you think "Hm. There's a good possibility I will be gone in this very cold, very frigid water within a week." What would be the habit?
I would still do miles because I'm going to show you how these miles add to the life of that day, but I don't think that I would overdo it and be a marathoner that day because then it would take to much out of my day for the other things that I want to do. But I would still do the number of miles that I'm going to tell you because I would do things during those mile that would make me happier, and there would be things that happened during the day after those miles that would make my day better.
So walking is extremely, extremely important. And let's talk about some of the more specific reasons about why I'm saying all these things and going on and on about walking. There's research showing that it helps with depression, that it helps with your bone density. It helps with so many things, so here's some more specifics. One study showed that in women, their ability to orgasm improved for the first hour after aerobic exercise. Think about that. This is like an aphrodisiac, orgasm enhancer. Suppose you had a pill that did that. What would that sell for? But here's something that's free if you just go walking with your lover, take your wife with you. And then you have sex when you come home. It's a free aphrodisiac that's been proven to increase her ability to have an orgasm.
Next reason. It does actually do more for your heart and your circulation than any pill. Now we've talked already about how your erection is basically a water balloon that's filled with the waters, metaphorically, the water is blood, and the ability to blow up the balloon depends upon your ability to pump blood into the balloon and the integrity of the blood vessels so that the veins are not leaking and the arteries are open, so the veins have to close off, so that there's no blood flow out of the balloon, and the arteries have to be able to pump enough pressure into the penis to blow it up. And the extent of the hardness and the size of the penis is going to be determined by that pressure.
So let's suppose that you had something that's been proven to improve your blood flow and improve your heart better than any other pill on the market. Better than diabetes pills, blood pressure pills. What would that be worth to you? What I'm saying to you is that walking is that magic bullet, and it was actually used, that exact phrase was used. "This is the closest thing we have to a magic bullet" in the New England Journal in reference to walking, but the walking has to be to a certain extent, so another research project, and we're getting to what that needs to be shortly, but, another research project showed that the greatest predictor of whether you're going to have heart attack within the next year is not even whether you smoke.
The greatest predictor is whether you've had a previous heart attack. That puts you at high risk, but the second greatest predictor, even if you've had a previous heart attack. The next best thing, the next best predictor of whether you will have a heart attack this year, and of course, that ... but whether you're going to have a heart attack is an overall guide to how healthy is your heart. The greatest predictor is your anerobic threshold, meaning what's your aerobic fitness level. Anerobic threshold has to be measured with a mass spectrometer, or it can be calculated. The most direct measurement is you breathe into a mask while you're walking and then you extend your intensity or you increase your intensity while you're walking and then jogging until your body has to swap from aerobic to anerobic metabolism. So the amount of oxygen you're burning exceeds the amount that you're able to pull in and supply. So that involves everything from the function of your lungs to the pumping ability of your heart. All the way down to the mitochondria within the muscle cells and how they're able to metabolize the oxygen.
You can actually measure the number of mitochondria, and within a week or so of starting an aerobic program of walking, you can see an increase in the number of mitochondria per muscle cell. And very elite athletes have a high number of mitochondria, so that makes them more efficient at burning oxygen.
So that is the number one predictor, second only to a previous heart attack. The problem is, and the reason it's not talked about by your physician is there's no drug to sell. There's no beautiful drug rep that comes into your doctor's office and say "Hey, you should prescribe walking because it's the best thing on the market for preventing heart attack" and improving erectile function and all the other things we're going to get to about mental state and such. And there's no ads on TV to tell you that. There's no one teaching you that because there's no money to be made. That's not necessarily a bad thing, but it's a thing, and it's the reason your doctor doesn't talk about it so much, or maybe yours does if you have a more progressive thinking physician.
So, I want you to think very deeply about that. What I just told you is that even if you smoke, if you have a high aerobic capacity, you're at less risk of a heart attack than if you don't smoke and your aerobically out of shape. Next reason for walking, hormones. You get this whole change in metabolism that comes from your hormones. It's not just about pumping blood around your body or even about increasing your aerobic capacity. Some things happen, your thyroid functions in a different way, in a more efficient way. You make some hormones that decrease your appetite for sweets, what you want to eat changes. The amount you want to eat changes. It's a free appetite suppressant that, rather than putting your heart at risk for a heart attack as some appetite suppressants do, walking actually improves your heart and decreases your appetite for about two hours afterwards.
This is another reason why I prefer aerobic exercise as opposed to say biking. When I did biking, when I did bike races and triathlons, and the reason I use the past tense is the risk of crashing, I just saw so many serious crashes. I decided it wasn't worth it. And noticed that my penis would go numb sometimes after biking a long way. That didn't seem to me to be a healthy thing, so before I ever read the research about this being associated with erectile dysfunction, it just made sense to me that anything that put my penis to sleep like your arm goes to sleep or your hand goes to sleep when you sleep a crooked way, in the same way, I thought, wow, something puts my penis to sleep doesn't seem to be a good idea, so that's why I keep using the past tense. I don't bike anymore.
But, when I did I noticed my appetite went up. When I lift weights heavily, there's a little bit of a decreased appetite immediately afterwards, but my overall appetite can become more ferocious, which again if I'm trying to build strength or I'm trying to build the size of my thigh muscles so I can be an Olympic biker, then maybe that's not such a bad thing, but when I'm trying to maintain a lean body and a healthy aerobic capacity, then perhaps a decrease in appetite, especially for unhealthy foods, is a good thing and that's exactly what happens, what's been proven to happen after aerobic exercise.
The other part, and I can ... this is part is maybe you're going to call science fiction, but it's real, is that there's over two hundred hormones made by the pituitary gland. And the possibilities of what might be going on that we don't the exact mechanism for but we see the effects of are really extremely exciting. What happens with those two hundred plus hormones with aerobic capacity we're not sure of, but we know that some of the things that happen with thinking are not just with the body habitus or the shape of the body and the function of it, but the way the thought processes go are extremely, extremely exciting.
For example, and let's talk about that thinking now. If you look at the people who are walkers, Harry Truman always wanted the reporters to go walking with him to talk with him. Steve Jobs is well known for the fact that he preferred to do meetings while walking in his per usual uniform at work was walking shoes. Charles Dickens wrote in the morning and then he walked and walked and walked for many hours around London even into the evening, late even hours, was a very robust walker. When you look at the prophets, Gandhi walked and he walked, he walked across India. Jesus, you read stories of him walking on the road to Damascus and walking from city to city, and if you look at the miles that he walked, he was a walker. And Beethoven, he composed in the morning and in the afternoon, he walked for hours and hours and hours through nature and took little slips of paper with him where he would listen to nature for sounds and rhythms and then stop and compose while he was walking.
Thomas Jefferson, brilliant statesman, wrote, you know, he was one of the founders of our, basically a revolutionary, we think our founding forefathers, but it's nice to stop and think about, hey these guys were risking their lives to basically tell the king to kiss off. These were smart guys but they were also bad asses, and Thomas Jefferson thought anything less than two hours of exercise per day put you at risk and made him less thoughtful.
Also, walking has been shown to decrease inflammation. There was this time that we thought people with arthritis should not move, but now we know that actually movement decreases the inflammation in people with rheumatoid arthritis, forms of inflammation. And of course, we are talking about the penis, and walking has been shown, it's almost cliché now, I don't know why we even need any more studies to show it. It's been shown over and over and over again that aerobic exercise improves the erection usually by about five on that five to twenty-five scale.
Now why would you not want to walk? There are some legitimate, there are legitimate reasons for not going walking. First it does take some time, and I don't know many people who feel like they have extra time. Most people between their work and their hobbies and their avocation and their vocation and their family and their spouse, their children and their friends, their clubs, their associations, their ... all these things that are pulling at them, they feel pressed for time. Part of the reason that Americans are probably sleep deprived, well no "probably". We are sleep deprived, most of us ... is that there's this urge to do more, do more, do more, and so to ask someone to do the amount of walking that I think makes people healthy, if it takes away from your time, you're not going to do it.
But of course, I'm going, if you follow my plan, you're going to have more time in your day if you do walking the way I show you how to do it. So I'll take that reason away from you, if you follow my plan.
What about the fact you have to go outside to do it. If you live in an area where's too hot or it's raining, in my area sometimes there's lightning, there's a lot of rain, we have the most inches of rain where I presently live of anywhere in the United States. Not the most days, but the most inches, and huge amounts of lightning. You may live where it's cold. You may live where there's traffic or crime, so getting out of your safety zone of your office or your house could be a problem, and then there's of course injury. Are we going to wear out our joints or twist an ankle or be hurt by a car, or mugged or shot or robbed. These are things that are legitimate concerns.
As far as the physical injury, there's this logarithmic curve where, if you look at the injury rate, there's almost nothing, if you're at home, of course you could fall off the couch or something, but generally speaking you're unlikely to be injured if you just don't walk at all. But if you look at the injury rate, it stays near zero until you pass about twenty-five miles per week. Once you pass the twenty-five mile a week mark, the injury rate goes up. When was in a marathon club, everybody had a little nagging something that was bothering them. Eventually I developed some heel spurs and people just get stuff when you start running twenty miles a day or you're doing eighty miles a week, a hundred miles a week. You start to have injuries. So I think that you should keep your range in a particular range, and particularly under the twenty-five mile mark to avoid those injuries.
So let's plunge into the way I think you should, can walk in order to avoid these problems. First of all, as far as the way to make sure you do the miles, I recommend that you do an out and back course. If you walk in a circle, it's too easy to stop. If you walk on a treadmill, it's too easy to just stop and get off the treadmill, and so there are times when you need to do that because of the weather and traffic and such, but as a general rule I recommend that you walk outside of your door, your hotel or your mother's house, wherever you happen to be that day. And you walk half the distance you intend to walk and then you turn around and you walk home.
Now you can split it up so if you're goal is to walk five miles a day, you walk two miles this morning and three miles in the evening, and so you walk a mile out, turn around and walk back, and you've done two miles. Or you could walk two and a half miles out and turn around and come back and you've walked five miles.
You realize that, when I say Cortez, that's the guy who came here, the conquistador who came here and his ... to the states and his men were about to rebel and wanted to go home, and he just took that option away by burning the ships. Then his men knew they had to either win or they would be destroyed by the natives. So they fought ferociously because there was no retreat. So in that same way, if you're walking laps, you can stop, but if you walk out and that's usually the easiest part of your walk is when you are starting, and then you have to come home unless you call someone to come pick you up. You have to walk home, so that helps us with the psychology.
Another thing is what I call my "ten minute rule." When you're ready to walk, never decide to not walk sitting on your booty. Get up, walk for ten minutes, and after ten minutes if you still feel like you don't want to walk, you can stop. But make that decision after walking ten minutes, and you'll discover that you'll have some of your most wonderful walks after you do that. After you think that you don't want to walk, but then you go ten minutes, you think "Hey, I feel pretty good" and then you want to keep going. So you just keep going. So do follow the ten minute rule.
So how far should you walk? I recommend that you make a goal of twenty-one to twenty-five miles a week. And I prefer a weekly goal because you might have days when you're busy and you can't walk at all. Or maybe you have a rest day because of your convictions with your religion, you prefer to rest on Saturday or Sunday and not do anything. That's fine. It's a good thing. So take that day off and don't walk at all. But if you make up for it, so if you're only going to walk five days, I prefer a twenty-one to twenty-five mile week. That gets you into the range of health, and that range has been show to decrease your overall mortality in half. It cuts it in half. So over the course of the coming year, it's been proven all cause, I mean it's getting shot by a thief, crashing your car, all cause mortality. I think this reflects the fact that it changes behavior. It changes what you do and where you go because how else can you account that there's even less trauma who walk to this amount.
But it doesn't happen with ten minutes a day or three miles a week, it starts to happen when you approach the twenty mile per week mark. So twenty-one to twenty-five miles per weeks, that could be three miles seven days a week, it could be five miles five days a week, it could be two miles today and five miles tomorrow, and six miles the day after that and one mile the day after that, but I would set a weekly pattern so if you intend to rest on Saturday and not walk at all, and Monday's a busy day, maybe you walk five miles on Sunday, and one mile on Monday, and four miles on Tuesday ... you get the point, but you decide how many miles you're going to walk each day and you keep that pattern.
I have found that that pattern changes for me depending on what's going on in my life. When I was a medical, when I was in my training as a resident, I trained for a marathon by running thirteen mile twice a week. Thirteen miles twice a week because I two days when I could be out of the hospital and fairly rested, but then the other days I was in the hospital often working all night, unrested, unable to go outside because of my duties within the hospital, so that was what I had, I had two days. So those two days went thirteen miles. For a total of twenty-six miles a week.
So I prefer that you spread it out more than that. Actually it's been shown that you do better even doing two episodes. Doing a walking session twice a day so you would have, you could have ten walking sessions per week. So I don't want to beat this to death, but those are the principles I would follow. And then, very, very importantly, keep a record. It's been shown over and over again, if you want to change the behavior, one of the most powerful things you can do is just start keeping a record of it. Keep a daily record, keep a weekly record. I prefer that it be actually on a piece of paper, although you can use your computer or your phone to record it while you're doing it.
I like it to be out of my computer where I can look at it, in a notebook or on the wall somewhere. But I can't stress the importance of this enough. As a matter of fact, I will almost guarantee that you will not be successful with your walking program if you're not keeping a record. It's been shown over and over and over again in research that people over-estimate the amount of exercise they do and the under-estimate the number of calories they eat. You just can't, some things we are just too biased to be accurate recorder, estimates of, and these are two of those things. So you will lie to yourself and as Shakespeare and many proverbs have said, we tend to lie to ourselves. So keep a record. Let me say it again, keep a record.
Okay. So another thing. Bring a few, as far as comfort along the way, don't make a big deal out of it. Bring a few bucks in your pocket if you want to stop and buy a bottle of water while you're walking, if you want to stop in the park. If you have a turn around point that involves a park bench or a rock that you want to sit on in the forest. Stop and sit on it. I don't want you to get hung up on how fast you're going. I want you to think about the distance. I want you to think about the distance. That seems to be the most important.
So, I want to stress this also. If you get hung up on your pulse rate, you will probably stop doing this. Imagine that I told you the most healthy thing you could do on the planet, would be go get a massage for an hour, seven days a week. Giving up that hour, I would actually have more trouble with that than walking because sitting there is a zombie state where I'm either meditating to a different level of consciousness, I'm not reading, I'm not learning, not doing all the other things you're going to learn how to do when you're walking, I'm just basically losing that hour for some benefit from the massage but probably more benefit, there's a decline in the amount once you pass a certain state. There obviously are some benefits from massage. I don't want to take away from that.
But too much of it, where I'm giving up my life, I'm back to the Titanic principle. So, I would quit doing it. The point being that even for something pleasurable, you can't do it, you won't do it consistently. Even if it's pleasant, if it's pulling from your life. So how can you expect to do walking consistently if you make it unpleasant. If you make it ferocious. Now you will reach a point to where you sometimes want to touch into the pain zone, maybe you want to do what's called the Fartlek System where you get your heart rate up by walking or jogging or sprinting depending on your level of fitness and the health of your joints, and then you slow down, you go fast and you go slow.
That's good, and maybe you have a time when you want to train. You're young enough, you're training as an elite athlete, and it's a different level of fitness. But if you're in this for the long haul to be healthy and you say to yourself "This walk is worthless unless I reach a certain level of pulse or discomfort" then you'll stop doing it. As far as the calories go, it's a physics problem. If you tell me you went walking for thirty minutes, that tells me nothing. You could walk a foot and stop and you could take a thirty minutes of being, a little bit over exaggerating here, but you could sure take thirty minutes to walk across a room, just move a foot, one of your feet every inch or so.
And you would be honest to say that you walked for thirty minutes. But if you tell me you took a body, a mass that weighs 50 kilograms and you move it a mile or a meter, then you can calculate that. It's mass times distance and that's foot/pounds. So if I take a hundred and ninety pound man and I move him 5,280 feet, then I've moved him 190 pounds times 5,280 feet and that you get the number of foot pounds. That are the work that, of a hundred and ninety pound man uses to move his body a mile. So when you look at calories per mile on the charts, what they're doing is assuming a twenty minute walk or a ten minute jog which ... and then there's extrapolating from that the number of calories. They don't actually know to get the exact number of calories you would use, the weight times the distance and you would have a finagle factor based on the amount of heat produced.
You only have about ten percent more calories if you're jogging versus walking. , So listen to that again. If I walk a mile, I'm going to burn the same number of calories almost as if I jog a mile, I'll just take twice as long to do it. And they'll be about ten percent more, that's it, if I do the jog versus the walk. So now knowing that, if you, as far as the calories go with the weight loss or the maintenance of weight, it doesn't really matter whether you walk or jog it. What George Sheehan used to say was "Go at a speed that you're able to talk comfortably. If you went a little bit faster you would be unable to talk comfortably." So if you're having to ... stop ... in the middle ... of a sentence ... like that when you're jogging then you may be getting into an anerobic range and that's not a bad thing, you can do that periodically by speeding up your walk or your jog, but it's not necessary to do that the whole distance where somehow you've wasted your time. Which unfortunately some health people, physicians/personal trainers teach people, and I think that's not a smart thing to do.
So you're going to walk at a speed that's comfortable, where, and if you want you can reach to a place where you're able to speak easily but faster might make it less easy, and you're going to record the distance. I wouldn't worry so much about the time. Just record the distance. And you're going ... most people are going to take about twenty minutes for a mile or about an hour to walk three miles. So think about that for a second. If you're going to commit to twenty-one miles a week, you're committing to an hour, and average of one hour out of your day, seven days a week, that's a big commitment.
Which brings us to the next part of this, which is when will you do it? And what can you do during that time so that you're not actually losing time, but gaining time. So as far as the "when" I recommend when you first wake in the morning, during which time you can do your affirmations, you know, some of the other things we'll talk about later. The affirmations are great first thing in the morning or prayers. Visualizations. Those three things go very well, even while walking, although you can do them while meditating, or sitting as well, but walking, affirmations are great when walking.
If you have a job that confines you and you have less freedom, you have to work strict brackets of time so you come in at eight and you work until noon and then you have an hour for lunch and then you have to start back at one, you will have a much healthier day if you walk during that lunch time and your lunch becomes a protein shake or something you can eat easily within fifteen minutes. I love protein shakes because you can drink them. You know exactly how many calories there in there. You can put fruit in there so you can have a couple of servings of fruit and some protein and you can consume it in five minutes and use the other fifty-five minutes for you walking.
Immediately after work is great, either, I prefer either before you leave work, so you put on your walking shoes and you walk at work, or you walk out the door. You walk and come back, you drive home, or you stop on the way home at the YMCA or somewhere, a park, or the forest, and you walk and then you complete your drive home. It's really, really difficult when you come home and there's family and they want to ... then immediately put on shoes and walk out the door, unless which is the next option, you may want to come home, and put on your shoes, and you walk with your spouse or your children and then you come home and you have dinner.
If you wait for the walk after dinner, it can sometimes become very, very difficult to have the energy. It's just too tempting to stay. So this is my least favorite time to go walking, immediately after dinner. I tend to get lazy and want to do other things. Right before bed, it's a really nice time to walk, although this is time for more leisurely walk, or the increase in heart rate can cause you to have trouble sleeping.
Now, as far as walking with other people, this brings me to another thing. It's very seldom that people want to walk at the same speed. So what do you do with that? I prefer to let the slower person set the pace or else you're going to interfere with the slower person's desire to walk. And with children, I let them walk ahead of me. If I'm with someone who's somehow not as fit or bothered by something, joints or something, I let them set the pace. Another wonderful thing to do, thought, if you're walking with children, and as a single father, with my children with me most nights of the day before they left the house, most nights of the week before they left, grew up and left, I had the ways of doing this.
One is that you walk back and forth in front of your house, so if you walk ... if you have a quarter mile marked off such that your house is in the middle of the quarter mile street, so a block is a tenth of a mile, so it's about, let's say, two blocks. A distance with your house in the middle of it, then you walk a block one way, you come by, you pass your house, you walk a block the other way, you just walked two tenths of a mile. The you back past your house and the point is that every time you pass your house, your checking the house isn't burning down, kids are in the front yard and behind the fence, everybody's happy, you actually never lose sight of the house if you're never more than a block away.
And you can back and forth again, I'm not a big fan of doing laps but that can be a way to do it, if it's necessary because of children. I lived at a place once out in a rural spot where my drive way was two tenths of a mile so I could walk out to mailbox and come back and that was almost a half a mile. My children could be out in the front yard playing around the house and I never lost sight of them. Everything was wonderful.
Another great way, I love this next way, to do your walking if you have small children is get to a school somewhere and then you put the children out in the middle of the football field and you walk around them. So they're out there with a ball or even in a playpen if they're that young, and you never lose sight of them, they're in the fresh air. They're having fun and you get to walk around them. Again it's a lap system, so it's not ideal, but sill pleasant and most high schools or YMCAs ... the high schools, of course if they're having a football game you can't do that, but it's a way to do that. On the weekends or during the off season when their track is available. They usually like that especially if you have children going to that school.
Another thing that I like is when you're at a sporting event. Let's say your children are practicing football or baseball or soccer, whatever their sport, you can walk around the field so instead of sitting there with the other parents, which of course, you need to do occasionally to be sociable and those connections that are so useful between parents. Instead of doing that, you can walk around the field and still see everything that's happening, and it's wonderful. So that's a great thing to do.
I sometimes even do that during the event, which is maybe a little bit disrespectful in the eyes of some people because it looks like you're not paying attention. But of course you're paying attention. You're more alert and you can cheer as well as anyone, you're just seeing ... you happen to go to the enemies' side because you go to the opponents side of the field if you make a complete lap. But I have done that, although I do that less often during events. It's more appropriate I think during practice.
Other things you can do to help your walks ... we just got through talking about how to walk and make it appropriate with your family. But what about just getting things done. What are some things you can do so that the walk doesn't take from your day, it adds to your day. Remember I said that I promised you that if you ... I'm going to show you how to make the walk not take time out of your day, but give time to your time. It's counterintuitive.
One thing you can do is make phone calls. You know how Steve Jobs did his meetings while walking? Well, how much time are you on the telephone? In most work places, it can be more than hour per day on the telephone. You'll be more alert. It's wonderful the technology we have. Right now, I'm using the air buds that come with an iPhone. So they're not getting tangles up with the cords. The sound is wonderful and I can have a conversation unless the traffic is really, really loud, and in that case, I use some Bose noise canceling earplugs that connect with a wire. It's a combination. It seals the air, so it's like wearing ear plugs and it counteracts the noise so you're able to hear very well.
My preference is to never be in traffic, that that's loud, that is that loud, and so the air buds are how I prefer to make my phone calls. I'm more alert, especially if it's a call that's going to be difficult for me emotionally, I have to deliver bad news or have a conversation, say with my attorney about something that's not pleasant. There's always battles to be ... we all have battles. We have battles with the forces that want to kick over our sand castles. You know, I live near the beach, and it's interesting. You can build a sand castle and then sit there in a chair and watch. And most people walk by and admire the castle, and ninety-nine out of a hundred people walk by without admiring it, they'll walk around it ...
But then you'll get that one out of a hundred who will come by and take pleasure in kicking over your sand castle. And those people are there. They're out there. And so we have out battles, we have the, just this thermodynamic force that says things go to a place of less organization. And if you want things to be organized with your business, with your personal life, with your spiritual life, you will fight battles. And for those conversations that require you're warrior state, walking is ... makes you more alert and it makes you a better warrior, so that's when you make those phone calls.
Next thing. What if I told you that I could give you the equivalent of weeks of free time in class. Let's calculate this. If you did an hour walking per day, and during that time you're listening to books, that's one hour times three hundred sixty-five days. That's close to four hundred hours. So to make the math easy let's say four hundred hours, and let's say that you have a forty hour work week, four hundred divided by forty is ten weeks. That's two and half months of full time, forty an hour per week, class. And when I was in college, I was not in class forty hours, but if you counted class plus studying then that was forty hours, sometimes more.
But so now that you basically ... what I'm telling you is this. If you listen to a book, every time you go walking that's equivalent to a full time class for two and half months out of your year. What could you learn with that? I know a Dad became a very successful investor and retired in his early fifties on his investments, and most of his learning about investments involved listening back then to cassette tapes. There was no ... the options were much less. There were no ... there was no iPhone. It was a cassette tape player to listen to. So listening to books is amazing what you can do.
Suppose I told you that you could go walking with Aristotle. You could go walking with Warren Buffet to learn about investing. You could go walking with spiritual leaders. You go walking and listen to St. Paul read his letters to you. You could walking and listen to the professors from the Ivy League colleges. It's amazing. That's exactly what you can do with a pair of earbuds and iPhone. So, would that add to your life? Would that make the rest of your life easier? And the other wonderful thing about this is I will promise you that you will, and that's my iPhone telling me something now, but I promise you that you will, you absolutely will retain more. You're going to learn more, you're going to have ideas that occur to you more if you're walking and listening to this.
What do you do if you have ... if you suddenly have a problem that you just have to solve. It's life or death. You have to figure this out. Do you sit at your desk? Intuitively, without thinking about it, without me telling you to do anything, you're going to get up and pace the room. And it's not just burning up energy, you're thinking better on your feet. I love something George Sheehan said. He said "I never trust an idea that I get while I'm sitting on my bottom."
Think about that. I'm not saying you don't get ideas sitting. You might get amazing ideas sitting and meditating, but don't trust it until you go walking and think about it.
So next thing I want you to think about is that don't just think about the books. You can pose yourself a problem and say "Okay. I'm going to walk and think about this problem while I'm walking." And my favorite way to do that, because when you're ... is to take note cards. Take a three by five index cards, two or three of them. Stick them in my pocket with a cheap pen hat doesn't matter if I drop it or I lose it, it gets wet in the rain when I'm walking. And then say "What I want to figure out" and then instead of pacing your office, this is going to be theme of this walk. To figure out how I should deal with this problem with my child. To figure out a new way to market this particular product in my office. And then you go walking.
If you want you can listen to a book that relates to that while you're walking, but you could also just listen to what's inside of you, what the piece of God that's inside of you, or the piece of you that's inside of God, however you want to think about that. And sometimes it's better to leave the phone off is what I'm saying and bring a pen and an index card in your pocket.
Just a safety thing I would say is that when you are walking with your phone, stop when it's time to fiddle with the phone so that you don't step in a hole or step in front of a car. Just stop walking, it's okay. Remember I told you it's more about the distance than your heart rate? I used to think when I was a teenager running track that if I was going to run five miles, if I stopped to tie my shoe, the five miles didn't count. You just had to run it start to finish without stopping. But I grew up. Don't worry about it if you need to stop. Just stop and fiddle with your phone, pull up the book, dial the phone, then after you dial the phone and you're talking, now throw your phone in your pocket and walk and talk.
Now we mentioned this previously but another wonderful thing to do while your walking is to have meetings. You know, we talked about how Steve Jobs preferred to have his meetings that way, especially if you have a meeting that's going to be emotional. It really helps if you're walking and talking. Even a creative meeting, you bring paper with you or you stop and you make audible notes or recordings on your phone, and you and the person you want to meet with go walking, or persons. It gets to be a little bit more cumbersome if it's more than three people. Two people. I think it's ideal for a walking meeting. But you can do it with more. Once you get more than about three or four people, though, it becomes more awkward because it gets hard to hear. But it's a great way to have a meeting.
Now let's talk some about gear. I will tell you my preference, and my personal preference for my feet .. I have high arches ... is High Balance. If your feet, it may be a different type of shoe. But I do recommend that you not skimp on the shoes. Find yourself some good shoes. Part of what threw my feet off is I decided it wasn't most ... it wasn't difficult enough to do my ten mile runs in shoes. I had to do them in boots, and if goofed up my feet. You need well fitting shoes, and I recommend that you go to a real shoe store. There's a subculture of people who just love to run, but they don't just love to run, they love shoes. And they study them. These days they even have computers that analyze your feet if you stand on something, and these people study shoes. They love making your feet happy.
You can go see a podiatrist and have them think about your feet. If you have feet problems and they're able to make inserts for your feet. They can make you whole, all the way up your spine happier. It's amazing what the proper shoes can do for you. But unless you have a problem with your feet. I think it's sufficient to go to a good running store. And when you walk in the store, id there's ... if it's an assembly line, and that person you're talking to is chewing bubblegum and they look like they've just started working there yesterday, find another person to help you or another store.
Persons who ... when you walk in you should see somebody who loos like they're a runner, and they should know ... they should want to talk to you about the shoes because they love them so much. You'll know you're in the right place.
As far as clothing goes, I used to make a big deal out of what I wore and in the cold weather it was one thing and hot weather ... you know, don't sweat it too much. The more difficult you make it to get out the door, the more likely you are to not go walking. These days I just throw on my walking shoes. I'll go walking in my suit. I'll go walking with a tie. I don't make a big deal out of it. Usually all I have ... I prefer, though, a pair of jeans and a comfortable shirt and my New Balance shoes. I gran my iPhone with my air buds and I'm ready to go. I might grab an index card and a pen.
I like the old school, four color Bic pens. I just still like that it's they're great for note taking. If I lose it, I actually like to lose them because that way somebody finds a pen that writes in four colors. It makes me happy. So I have a four color Bic pen I throw in my pocket with an index card. And I like to get the index cards that have my name and address printed on them that I get from a stationery store, so it's ... if I make notes on it and hand it to somebody, they have my contact information. So that's all I need.
I might grab a hat if it's cold or gloves. If it's raining I don't worry about it. I just leave the iPhone at home and go walking or I put it in a plastic bag in my pocket. But lightning keeps me home. If it's too icy where I'm going to fall and break something, I stay home. And when I stay home, I mean, I go walking on an elliptical trainer or a treadmill. I have a gym that's close to me that's twenty-four hours. I prefer a twenty four hour gym that's available so it matches my schedule. You may not have something like that available. If you don't, then I recommend that you by yourself an elliptical trainer or a treadmill.
I like ellipticals because they don't put a strain on your joints. But have those for your bad weather times. I prefer to go outside. There's something about the outside that's really good for you, I think. But you may live in a place where the crime's too bad or the traffic's too bad. If you're having to stop and just wait so much that it's a nuisance because there's so much traffic, then get to a place where there's an elliptical trainer and do everything else the same. You can listen to the books, you can make the phone calls, and if you keep the pace at a comfortable pace, you'll still be able to do your training and not jump off before you're done.
Adjust the tension or if it's too hard because ... and you feel more like you're lifting weights or pedaling up hill on a bicycle, then you're elliptical trainer is either the wrong machine or the settings are off. Make it to where it feels about like you would feel if you were walking up a one percent grade or on flat land. If you're on a treadmill, that's usually about a five percent grade. If you're on elliptical, you just have to fiddle with the setting on the tension to where it feels about like what you would feel if you were walking on flat land.
If you want you could use a Garmin watch or an iWatch to help you with your keeping track of things. I think that's useful and fun and it helps you with your record keeping. I have a walking app on my phone that I'll put the link to. All the links to all this will be beneath the podcast. Everything that I've talked about, so I have an app that's wonderful. It keeps track of everything, and I even have it send an email to my EverNote account so there's a record of where I went that day and what the weather was like. And it's nice to have maps of where I've walked, whether I'm visiting family or happen to be on a business trip.
So those are my tips for walking and I hope what you've seen is it's amazing. I just told you how to get almost three months of full time class and remember it better than if you were sitting in a classroom with the great thinkers of the world. I've told you how to do meetings in a way that Steve Jobs have done it. And how to do creative work in the way that Beethoven and Charles Dickens did it. And the way revolutionaries like Thomas Jefferson thought about overthrowing a fricking King. And these were walker people. And I've also told you how, as a side effect, you're going to have a healthier penis that's straighter. You're going to have decreased inflammation if you have Peyronie's. And it's going to be harder because you're going to able to pump blood into that thing because you're heart's going to be functioning better and you're blood vessels are going to be more open to pumping blood.
So there you go. I sure hope you find this useful. I hope you'll stay in touch with me, subscribe to my emails. Join our group. See the doctors that I've trained and stay in touch and let me know how you do.
Thank you very much.
Peace & health,
Inventor of the Priapus Shot® Procedure
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Hello this is Charles Runels and we're still talking about ways to help Peyronie's disease and erectile disfunction. Today we're talking about testosterone. Testosterone is associated with Peyronie's disease, we're not sure exactly why, but I have a theory about that. Peyronie's has an autoimmune component to it and for some reason men are less susceptible to autoimmune problems than women, so women have more rheumatoid arthritis, they have more lupus, they have more lichen sclerosus. All those things are caused by the immune system attacking itself. They have more multiple sclerosis and it's been shown that men who get MS, more likely to get it, as they approach andropause when their testosterone levels fall. Men are more likely to get Peyronie's disease if they have a low testosterone level. Likely that has to do with the protective effect of autoimmune, protecting from an over-active autoimmune system by having a normal testosterone level. There are other reasons for correcting your testosterone level and I'll get to those.
First I'd say that after treating many thousands of women and men over the years, I would say that the primary hormone that regulates sex drive and erectile function is testosterone. It's almost impossible to have a normal libido without it, for a man or a woman. It's difficult to have normal erectile function. Without it the penis actually starts to shrink, just like the muscles would shrink and atrophy without testosterone. Other benefits of it though would include the heart, which is also a muscle and so testosterone is needed to maintain the health of the heart. There was at one time this idea that perhaps testosterone was dangerous to the heart, but now we know that not to be true. It's the opposite is true, that if testosterone level is low, the heart suffers and can become weaker. Of course muscle mass is not just about looking pretty, it also has to do with functioning.
As people age, the number one reason for going in the nursing home is people becoming too weak to get to the restroom, and they start urinating on the floor. Muscle is not just about being attractive or looking fit, it has to do with functioning and as people get older, it becomes crucial to be able to move and there's like a bank system, whatever, as you age and the muscles become less forceful, whatever you had banked as a young person is drawn upon and if you didn't bank a lot of strength when you were young, there's less to draw upon and you're more likely to become feeble as you get older. Depression, we know that having a low testosterone level is associated with depression and correcting it help, but not only that, concentration and focus and just energy level. I've also seen some people who at one time were just absolute lawyers, people who were bouncers or special forces, military, or high intensity athletes. You know, snow board athletic acrobatic people.
Then they come to me with panic attacks and you think, how out of character that here's a man that a few years ago was in a situation where he was required to be very brave and now he gets panic just sitting around the house, and when you do blood work on those men, oftentimes their testosterone level is very, very low. Which can be traced back to oftentimes a head injury and pituitary function is not working and so they are completely out of character and become like a castrated animal basically. Going from very bold to very panicky and fearful because they lost their testosterone. Bone mass is also related to testosterone levels, and even more so than with muscle there's a deposit of calcium into the bone and inaudible 00:04:32 bone is not static like a board that supports your home, bone is constantly remodeling by osteo-blasts and osteoclast, adding and taking away calcium to the bone itself. As a young person there's more deposits and as people get older there becomes more withdrawal on a flow system. There's always coming and going of calcium into bone.
There becomes more going of calcium instead of coming as people get older. Testosterone helps hold onto the bone, it helps to bank bone, it helps keep bone strong. Weight. This is sort of tricky because weight, part of the reason that men have a lower percentage of body fat is because they have a higher testosterone level and yet, if you use testosterone as standalone to lose weight, it will not work because what will usually happen is people increase their, not only their sex drive, but they'll increase their appetite for food. If they don't counterbalance that with more exercise, they just gain weight. Although it's true that testosterone as a general rule decreases percentage of body fat, if it's not part of an overall health system that includes exercise and watching, being careful about how you eat, then it leads to weight gain. On the other hand, without testosterone, a man or woman can exercise ferociously and still have very much difficulty maintaining a normal body weight, and maintaining a lean body.
It's crucial. Those are some of the reasons why you would want to use testosterone. Why would you not want to use testosterone? One reason is some men worry about it effecting the prostate. Now we know after multiple, multiple studies, over and over again for the past 20 years, that having a higher testosterone level does not correlate with prostate cancer. After a man has had prostate cancer, there becomes this strategy to sometimes lower testosterone levels to help keep it from recurring, but most urologists these days will tell you that at some point after a man has become cancer free for a while, they will put him back on testosterone. So prostate cancer is not a side effect of testosterone replacement. My personal opinion is that even though the evidence is still not conclusive to some physicians, I think prostate cancer probably evolves out of chronic inflammation and chronic prostatitis. Prostate cancer correlates more with that, with a history of sexually transmitted diseases and chronic prostatitis than it does with testosterone levels. We know that chronic inflammation leads to cancer, and we know that infection leads to cancer to in other areas like the cervix.
Other things that make a man may not want to be on testosterone do include weight gain, but as I mentioned before, this is not a problem if the man's maintaining an active lifestyle. You can't undo a sedentary life and a very self-destructive diet by just using testosterone. Using testosterone along with an active lifestyle and a healthy diet will improve the results of those two things. Another side effect of testosterone can be acne, again this can be controlled in most people by just watching the levels of testosterone that are given, or just treating the acne itself, usually with Retin A or something like that. Hair loss is a, male pattern hair loss can happen in men and women who use testosterone. I don't have a solution for that. That's guaranteed. Although there are helps, inaudible 00:08:58 is one that can be used topically to block the conversion of testosterone to inaudible 00:09:03 or testosterone and can help with that. Lipids, some people have worried about testosterone causing problems with Lipid profiles, but we now know that in most people testosterone improves the cholesterol and Lipid levels and profiles.
There was a time when people worried about the liver. The liver problems that arose from body builders using testosterone came from using oral testosterone supplements. Not from parental or avoiding the gut, because when you take testosterone by mouth, it passes through liver before it gets distributed to the body and that strains the liver to convert it or to process it. That can lead to liver problems, but when you take it as an injection or a cream and you bypass the liver, then that's not a problem. Actually, it can help regenerate the liver. There are studies showing that when a man has, for example, cirrhosis of the liver, alcoholic cirrhosis, and if he stops drinking the testosterone can be used to help regenerate apatisites 00:10:13, or regrow the liver. Some things can't be regrown, but the liver is one of the organs that can actually regenerate itself. Those are the basic why's and why not's of testosterone. If a man is suffering with Peyronie's disease, I would highly recommend that he consider being, making sure his testosterone level is normal. We're getting to how to check it and how to replace it.
Same with erectile disfunction, and any of those other problems that we mentioned. Now, let's talk about how to replace testosterone. First to measure it is a little tricky because it varies during the day. It's usually higher in the morning and then there's a sine wave sort of response, but the highest level is usually in the morning. Some people make a big deal out of if you replace it, trying to somehow replicate that up and down that happens on a daily basis. There's really no evidence that's convincing to me that that's necessary. That's one of the arguments, for example, of using a testosterone cream is to apply it in the morning and it's higher in the morning. Before we get to how to replace it pharmaceutically, it's worth thinking how it might be replaced just naturally. Here are some of those strategies. One is just maintaining a healthy lifestyle. Those things your mother told you to do; sleep. Sleep is not just some thing that your body rests, it seems sort of a simplistic way of thinking about it.
What really is going on is that your brain somehow, which we don't fully understand, does things biochemically. For example, the pituitary gland, which is the master gland that tells the others what to do and how and when, the pituitary gland controls your adrenals, your testicles, your thyroid. It secretes over 200 hormones that we know about, over 200. We're not sure what all it's doing, but we do know that it creates a separate spectrum of hormones in deep sleep, as opposed to when walking around or awake during the daytime. Those deep sleep hormones have to do with regenerating, not just the brain, but the entire body. There's a spike in growth hormone for example. Sleep is one of the things that can help regenerate or elevate testosterone levels. Also, a high sugar diet has been show to lower testosterone levels and so a lower carbohydrate diet that's higher in protein is helpful. Occasional fasting, not extensive, but periodic fasting on very low calorie diet for one or two days every week to a month is something that will boost testosterone levels.
The old-school body builders like Vince Geronda 00:13:24 were big into periodic fasting, not as a way to lose weight, but as a way to gain strength. Empirically they figured out that it raises hormonal levels and helps anabolic repair. Those are some of the things that we know. Other things that are less talked about that we know is for example, there's evidence that the more a man ejaculates the lower his testosterone level will become. This thing that somehow it doesn't, there's really no downside to indiscriminate masturbation, is really false. Those are the natural things that can be done. Now, if that's not helpful for whatever reason, and it can happen at any age, things that might lower testosterone level even at a young age include head trauma, even trauma to the head that does not cause loss of consciousness can effect the pituitary gland. It's dangling from a little tiny stalk that with sheer forces can cause micro-infarction's and decrease circulation to the pituitary. Head trauma.
It could be from playing sports or a fall, or post-concussive syndrome from a nearby bomb in a war situation. It's a known phenomenon that's been talked about in the New England Journal. Other things that might lower testosterone in a young man include smoking pot, which will not only lower testosterone, but raise estradiol levels and taking narcotics. Narcotics like Oxycontin and Lortab 00:15:10, those morphine-like pain medicines basically put the pituitary gland to sleep. There's less luteinizing 00:15:18 hormone and folical stimulating hormone. Which are the hormones that tell the testicle to make testosterone. Pituitary goes to sleep and the man makes less testosterone when he's on narcotics. Assuming all these strategies have been tried and the man still has a low testosterone level, the pharmaceutical ways to raise it, actually before we get to that, let's talk about measuring testosterone. Testosterone is up and down as we mentioned before, but not only is it up and down, but it's bound so some of it is floating free in your bloodstream, and some of it is connected to a protein.
Sex binding globulin. If you measure a total level, it can be misleading because you're measuring not just the free part, which can actually activate your tissue and do the work, but the bound part. Picture it like a train and the proteins are like the box cars on the train that are carrying the testosterone around, but it's only the testosterone that jumps off the box car, jumps off the train and into the bloodstream that's doing any work. If you measure all the testosterone that's on and off the train, you can't really tell what you're doing. The way to get to that, the most accurate way to get to the actual free testosterone, which is the part that's jumped off the train, is to measure the total amount of it, that's on the train and off the train, or what's bound to the protein and what isn't, and also measure the sex binding globulin. Then you can calculate what part of it's free.
Then looking at that, my suggestion is that you put your testosterone levels in the upper 25% of normal for a 35 year old man. You don't need to be 18, but you don't need to let it just taper off down to nothing either. Okay. Once that's measured and it's determined that you need replacement and if you do the things that you know to do to try to bring them up normally, and that's not helpful, then some pharmaceutical options include Human Chorionic Gonadotropin 00:17:46, testosterone pellets, injections and a cream. Now, HCG, or Human Chorionic Gonadotropin, is a small amino acid peptide protein like luteinizing hormone, and so the body thinks it's luteinizing hormones, the testicles do, so when you use Human Chorionic Gonadotropin the testicles think the pituitary gland just told them to make more testosterone. For a young person who's close to normal, that is a good option. It's given sub-Q like an insulin injection twice a week, usually 2000 units twice a week. It's an odd hormone though in that if you go up on the dose, it can actually cause less response. It's better to start low and be patient.
You're fertilizing testicles, so you won't really know what the results of it are until you give it six to eight weeks, and then re-check your testosterone levels. The next thing that can be done are testosterone pellets. The downside to these are that whatever you put in, it's there for the next three months. There are those who've made a really nice business out of doing lots of pellets. My suggestion is that you do not use a pellet until you used injections to get an idea about what the ideal dose for you is, because if the pellets not enough, you're sucking wind. If it's too much, then you deal with side effects. Although pellets are a very elegant treatment, I think it's better to save that until after you've determined a proper dosage by using an injection of testosterone. Again, this is my opinion and there are many excellent physicians who have a different opinion and have amazing results. Medicine is still an art, and there are some parts of it that there's still some discussion about what the best strategy is.
I'm acknowledging that pellets are a wonderful option, whether it's something you start with or it becomes a second step, it's up to you and your physician. My preferred first step is injections using depo testosterone, most men should start with 200 milligrams IM every 14 days, or 100 milligrams IM every seven days. This is one where I do not prefer a compounded hormone because it seems that the quality variable varies. My preference is a name brand testosterone injected IM every two weeks. There is are also testosterone creams, the downside of the cream is you don't really know how you're absorbing it. People forget it, one day you do something and you're sweaty and you sweat it off. The next day you don't. There's just too much variability in my opinion. I'm not a big fan of testosterone creams. The problem with the cream is after being on it for six weeks, if you don't see anything changing, you don't really know what you have unless you do blood levels because you don't really know how much of it you've absorbed.
If you do injections, you know that you've absorbed what you injected and then you can make decisions based on that. Those are some of the ideas and strategies with testosterone. I highly recommend that every man know what their level is and that they do something to maintain healthy levels. On the other hand, testosterone is not the end-all, be-all, for example, a prolactin can decrease sex drive and make a man impotent even with amazing testosterone level. As can a low thyroid level or a very low growth hormone level. So it's not the magic cure, but it is a necessary ingredient and I highly recommend that you speak with your physician about it if you're having problems with erectile disfunction or Peyronie's.
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Priapus Shot® Procedure
The Priapus Shot® procedure indicates a specific way of treating the penis with blood-derived growth factors extracted from the man’s own blood (autologous). Some people call these blood-derived growth factors platelet-rich plasma (PRP) but there may be growth factors in plasma we don’t yet know about that do not come from the platelets. The name “Priapus Shot®” is registered with the US Patent & Trademark office as a “service mark” to protect patients by indicating a specific protocol. The name is not a synonym for the injection of blood in to the penis—such a definition would not be specific enough to indicate any particular quality of care. and so would not warrant protection as intellectual property.
The trademark defines a specific method of that providers agree to follow and develop; this agreement offers quality control and is followed and developed by over 500 urologists, interventional radiologists, family practitioners, and internists in multiple countries and by faculty in medical schools where further studies are being done.
The Priapus Shot® procedure protocol also involves patient selection, patient evaluation & education (including explanation of consent), preparation of the PRP, local anesthesia, PRP injection, post injection use of a penis pump on a daily basis, and a daily dose of tadalafil (in come men). Other post injection steps can include: stopping smoking, CoQ10 (12), vitamin E (13), Trimix, and aerobic exercise. Protocol steps vary depending on the patient and those variations also comprise the Priapus Shot® protocol.
Patient selection includes identifying those who may need hormonal treatment, or family counseling, or vascular surgery, as well as those who may have co-morbidities or who may be taking drugs that interfere with sexual function. Some patients are not treated with the Priapus Shot® protocol because another treatment or no treatment is more appropriate.
The policy of most of our providers of the procedure offers a complete refund to any man who is not happy with the Priapus Shot® procedure.
Consulting with the patient includes informing him that unexpected side effects could occur and the results will vary with some patients seeing no benefit. Antibiotics fail in 1 in 5 people in the hospital with pneumonia—resulting in death. Antibiotics “work” but do not work for all people. The same can be said for most all procedures including the Priapus Shot procedure.
The preparation of the PRP involves a device approved by the FDA for isolating PRP from whole blood for autologous use. Since blood is not a drug, it is not governed by the FDA but the devices used to isolate PRP for injection back into the body are regulated by the FDA. Multiple kits have gained FDA approval. Some of the approved kits include Regen, Magellan, TruPRP, Eclipse, Pure Spin, Harvest, & Emcyte. There are over 8,000 research papers on pub med discussing the science of PRP, and not one serious side effect has been documented when FDA approved kits were used to prepare the PRP.
Most men find the procedure very comfortable if a topical lidocaine cream is applied to the penis about 15 minutes prior to the procedure. A very small needle (1/2 inches long, 30 gauge) needle is used for the injection. However, some men do ask for a dorsal nerve block which can easily be done using 2% lidocaine for a near painless procedure (this same block can be used for prosthesis placement—so it makes a 30 gauge needle completely painless for most men.
An early report that PRP may be useful in the penis appeared in a paper published in Urology in 2003 mentioning that, in animal models, using blood-derived growth factors injected into the penis successfully treated erectile dysfunction and also mentioned that such a strategy may be feasible in men— actually providing a way to correct the underlying pathology (1). In contrast, Viagra and Trimix do not correct the underlying pathology of decreased penile circulation.
Another animal study in 2010 showed that transferring adipocyte derived stem cells (ADSCs) into the penis caused endothelia cell growth (new blood flow) as well as increased nitric oxide activity in the dorsal nerve (harder erection). But, the ADSCs were tagged before injection (to keep up with them) and most of the injected stem cells died! So the improvement seen was not from maturation of the ADSCs but rather from recruitment and activation by growth factors of stem cells already in the body—indicating PRP may demonstrate a similar effect (2).
Dr. Virag (also a pioneer of Trimix injections) published research demonstrating improvement in erectile function, size, and correction of Peyronie’s disease with the use of PRP. His studies both published (and to be published) demonstrate a mean increase of 7 on the ED Intensity Score when PRP is injected into the plaque and into the corpus cavernosum of the human penis (3).
One of the growth factors found in PRP (over 20 known) includes vascular endothelial growth factor (VEGF). In one animal study, the animals were castrated causing a shutting off of testosterone to create a penis that demonstrated, on microscopy, atrophy of smooth muscle and nerves as well as endothelial cell pathology. Then another group received VEGF injections directly into the corpus cavernosum along with castration. VEGF injection into the penis at the time of castration prevented the atrophy as effectively as did testosterone replacement. Moreover, VEGF reversed cavernosoetric findings of leakage (4).
The above studies and others not cited indicate an improvement in the health, circulation, and strength (density) of penile tissue with injection of blood-derived growth factors into the penis.
What Goes with the Shot?
In regards to improvement in erection firmness, the Priapus Shot® protocol also includes a recommendation of aerobic exercise which by meta analysis of 5 randomized controlled studies using the Erectile Function Scale showed an increase of 5 (5,6).
As previously stated, the complete Priapus Shot® protocol, also includes the use of a penis pump, which as a stand-alone therapy has been demonstrated to improve erection both as part of a penile rehabilitation program as well as an adjunct to other therapies (7,8).
This same penis pump strategy, even without the PRP, has been demonstrated to increase penis size by 2-3 cm, while traction (another physical therapy that can be included as part of the Priapus Shot® protocol) was shown to increase penis length by 1.5-2.5 cm (8, 9). Adding PRP to the protocol shows improved results according to data collected by urologists currently utilizing the Priapus Shot® protocol (to be presented). The 2.5 cm improvement seen with the penis pump alone is in the 10-20% growth range for the average sized penis. As previously stated, while patient results vary, any patients that are not happy with the procedure are given a complete refund.
Ultrasound studies of humans, post treatment, by Dr. Virag and by other physicians who offer the Priapus Shot® protocol demonstrate improved blood flow, an increase in endothelium (improved health), and decreased plaque size. Dr. Joseph Banno of Chicago recently presented a paper showing the Priapus Shot® procedure decreased venous leak as well as increased intra-penile arterial pressure.
Dr. Virag’s studies, using the injection of PRP as a stand-alone (without physical therapies), also demonstrate improvement in the angle of the penis in men suffering with Peyronie’s disease (3). Also, strict adherence to a penis pump regimen is part of the Priapus Shot® protocol and the pump alone improves the angle significantly in over one-half of those studied in one study in the British Journal of Urology (10). This same study demonstrated growth of the penis using the pump alone (without the PRP injection). The PRP alone, in Dr Virag’s study, out-performed the pump with demonstration of remodeling of the plaque. I recommend using both methods: vacuum pump and Priapus Shot®.
Studies show that the non-surgical treatment of Peyronie’s is most effective when a synergy of multiple modalities is engaged (11). So, the Priapus Shot® procedure includes the injection of PRP (demonstrated effective by Dr. Virag) combined with daily physical therapy using a penis pump for ten minutes twice a day and a daily low-dose of taladafil. Other modalities in the Priapus Shot® procedure that have been demonstrated to be synergistic include the following: stopping smoking, CoQ10 (12), vitamin E (13), trimix, and aerobic exercise. Such strategies are not intended to take the place of surgical correction or of the use of chemical surgery with collagenase—but rather to offer the man suffering with Peyronie’s disease the optimal non-surgical treatment as a first step with surgery reserved if non-surgical therapies fail.
The penis pump alone (part of the Priapus Shot® protocol) has been shown to improve the effectiveness of Cialis and of Trimix injections (8). We are seeing men decrease the dosage of Viagra and/or Trimix by about 50 percent when the complete Priapus Shot® protocol is used. The Priapus Shot® protocol does not intend to make any particular therapy obsolete (including surgery) but rather to offer a protocol for enhancing an overall, synergistic approach to correcting penile pathology. However the surgical treatment of Peyronie’s disease can be unsatisfying and lead to serious complications (14); we (the Priapus Shot® providers) are seeing the safety profile of PRP and the Priapus Shot® protocol as offering an appealing conservative and often effective step to take before proceeding to surgery. The risk from PRP is certainly much less than for surgery and less than for collagenase—offering another reason to start with the Priapus Shot® when treating Peyronie’s or erectile dysfunction.
When considering the duration of effectiveness of the Priapus Shot® procedure and risks involved, you may find it helpful to consider the nature of the cell biology employed. A review article considering the basic science of PRP discusses the fact that the autologous growth factors are exactly what’s generated to propagate healing should the man have surgery. The healing peptides, chemotactic factors, and pluripotent stem cells employed are exactly what’s generated by the normal healing process and offers no inherent risk for infection or allergy (16).
In over 8,000 papers published about PRP on pub med, there is not one serious sequelae reported that I can identify (multiple review articles address safety). This seems logical when you consider the material being injected is autologous and normally produced to help healing and to fight infection.
Wound care studies demonstrate the nature of multiple tissue types being regenerated (with no reported risk of neoplasia in multiple biopsy studies (17-20).
Moreover, in rat studies (where biopsy of the dorsal nerve is feasible), PRP has been shown to help regenerate nerve tissue and restore erectile function when prostate surgery is modeled with crush injury to the dorsal nerve (21,22). Some studies of stem cell therapies demonstrate that the stem cells do not actually mature into healthy tissue but rather signal for the improvement of the involved ganglion and nerve conduction by recruitment of stem cells to the area - exactly what happens with PRP.
Stem cells are not directly prepared as part of the Priapus Shot® procedure, but we are seeing similar results as what’s reported with stem cell studies. Stem Cell studies often use PRP as a carrier for the stem cells, bringing into question which is the active agent (23-24).
The idea of safety is further emphasized by the literature indicating that not only are there no reports of serious allergic reactions to PRP, but research also shows that PRP can attenuate the autoimmune response. One split-scalp study (with placebo control) showed improvement in alopecia areata, with the use of PRP, that out-performed triamcinolone (25). Another study using PRP in the genitalia of women, showed improvement in lichen sclerosus as determined by both patient survey and by 2 blinded dermatopathologists (26). This attribute of PRP (attenuation of the autoimmune response) could partly explain the effectiveness of the Priapus Shot® protocol for the treatment of both Peyronie’s disease and erectile dysfunction since Peyronie’s is thought to be partly caused by an autoimmune response.
Hard & Easy Cases
- Penis Growth-Only 60% of men achieve 1/2 inches or more in growth (circumference and length). But, men in that 60% sometimes see up to 1.5 inches in circumference & length (often after 2 to 3 procedures).
- Men with long-standing vascular disease see less response. If the blood flow going to the penis (ileac arteries) is blocked, then the Priapus Shot® injection into the penis will not help much. The man needs a vascular surgeon. One way to get an idea here….if the man sees absolutely no response when taking Viagra or Cialis for more than 2 years, then he may have blockages or other problems that the Priapus Shot will not help.
- Post op for prostate surgery as part of a penile rehabilitation program. If the man could achieve erection before the surgery, the following the Priapus Shot® protocol could be very beneficial (even if it’s been 2 or 3 years since surgery).
- Improved firmness of erection in the man who can already achieve erection. Typical results are that he may be able to cut the dose of Viagra or Trimix in half (but still need the drug) or if he needs only a low dose of the drugs he may be able to stop using them.
- Improvement in lichen sclerosus. This is HUGE since lichen sclerosus appears on the foreskin with severe discomfort and often recurs even if the man has a circumcision.
- Peyronie’s Disease. This possibility is another HUGE benefit of the procedure—with the Priapus Shot® probably safer and more effective than collagenase injections (research to be published soon). If a man undergoes surgery for Peyronie’s disease, the curvature often recurs later since the autoimmune process continues. Also, with surgery, there can be infection and shortening of the penis. None of those side effects have been seen with the Priapus Shot® procedure (side effects include INCREASE in size in most men with Peyronie’s).
In summary, multiple studies support the idea that blood-derived growth factors (when prepared in a proper way using a kit approved by the FDA for the preparation of PRP), as used in the Priapus Shot® protocol, support the health and function of the penis. Erectile dysfunction is associated with anhedonia, and successful treatment leads to better function, better relationships, and more pleasure in life (27).
Hope you find this helpful!
Peace & health,
Charles Runels, MD
Inventor of the Priapus Shot® Procedure
2. Garcia MM, Fandel TM, Lin G, Shindel AW, Banie L, LinC-S, and Lue TF. Treatment of erectile dysfunction in the obese type 2 diabetic ZDF rat with adipose tissue-derived stem cells. J Sex Med 2010;7:89–98
3. Virag R. A New Treatment of Lapeyronie’s Disease by Local Injections of Plasma Rich Platelets (PRP) and Hyaluronic Acid. Preliminary Results. e-mémoires de l'Académie Nationale de Chirurgie. 2014;13(3):96-100.
4. Rogers R. Intracavernosal vascular endothelial growth factor (VEGF) injection and adeno-associated virus-mediated VEGF gene therapy prevent and reverse venogenic erectile dysfunction in rats. International Journal of Impotence Research. 2003;15:S24-9.
5. Lamina S, Agbanusi E, Nwacha RC. Effects of Aerobic Exercise in the Management of Erectile Dysfunction: A Meta Analysis Study on Randomized Controlled Trials. Ethiopian Journal of Health Sciences. 2011;21(3):195-201.
6. Esposito K, Giugliano F, Di Palo C, et al. Effect of Lifestyle Changes on Erectile Dysfunction in Obese Men: A Randomized Controlled Trial. JAMA. 2004;291(24):2978-2984. doi:10.1001/jama.291.24.2978.
8. Pahlajani G,Raina R, Jones S, Ali M, and Zippe C. Vacuum erection devices revisited: Its emerging role in the treatment of erectile dysfunction and early penile rehabilitation following prostate cancer therapy. J Sex Med 2012;9:1182–1189.
12. Safarinejad M. Safety and efficacy of coenzyme Q10 supplementation in early chronic Peyronie’s disease: a double-blind, placebo-controlled randomized study. International Journal of Impotence Research. 2010;22(5):298-309.
16. Sanchez-Gonzales J. Platelet-Rich Plasma Peptides: Key for Regeneration. International Journal of Peptides. 2012;10:1-10.
18. Yuan T, Zhang C-Q, Wang JH-C. Augmenting tendon and ligament repair with platelet-rich plasma (PRP). Muscles, Ligaments and Tendons Journal. 2013;3(3):139-149.
20. Conde-Montero, E., Horcajada-Reales, C., Clavo, P., Delgado-Sillero, I. and Suárez-Fernández, R. (2014), Neuropathic ulcers in leprosy treated with intralesional platelet-rich plasma. Int Wound J. doi:10.1111/iwj.12359
24. Fandel T. Recruitment of Intracavernously Injected Adipose-Derived Stem Cells to the Major Pelvic Ganglion Improves Erectile Function in a Rat Model of Cavernous Nerve Injury. European Urology. 2012;61(1):201-210.
26. Goldstein A. ISSVD 2015 Abstracts. Autologous Platelet Rich Plasma (PRP) Intradermal Injections for the Treatment of Vulvar Lichen Sclerosus. Journal of Lower Genital Tract Disease. 2015;19(3):S1-S25.
3 Questions about the Priapus Shot® Procedure
- P-Shot® increase size much? With or without the pump?
- Other methods for size- pump work alone? If so how to use and for how long etc?
- Physical techniques using the hands or traction?
Consult your doctor before doing anything & before stopping anything your doctor told you to do...
- Priapus Shot® providers (click to find closes one to you wold-wide) <--
- Priapus Shot® for size (research here)<--
- Pump use-a detailed analysis (click for video) <--
- Anytime...for As Long As You Want: Strength, Genius, Libido, & Erection by Integrative Sex Transmutation (a 15-Day Course for Men)<--
- Penis Growth Course (an audio course. click to review)<--
- Priapus Shot® Research (click for links to the research with video explanation)<--
- Application to Become a Certified Provider of the Priapus Shot® Procedure (click to see application form)<--
Transcription of Podcast
Question 1: Does the P-Shot® increase the size much and with or without the penis pump?
First of all, what's much?
If you take the average-sized penis of 6" in length and you increase the circumference by 1 inch (2.5 cm), then you double the volume of the penis!
That's not enough that you're going to make a shocking display on the next porn movie, but it's definitely enough that your lover will be able to feel the difference.
First of all, nothing is 100% especially the Priapus Shot® procedure for size. I am first to tell you that it is very frustrating when I get a phone call from someone like I did a few months ago; a fellow tells me that his full erection is 2 inches long—2 inches long! His full erection is only 5 cm long and he's never been alone with a woman because he's embarrassed by the size of his penis.
With this man, the size of his penis is NOT just about being proud of his penis in the shower. He suffers with a social problem. Unfortunately, I cannot offer him a guaranteed solution. Just like with muscles, it appears that the more you have, the easier it is to grow. You can watch a guy who's already muscular and when he goes to the gym his biceps grow like crazy, while the man with little muscle tone struggles to increase arm size and strength.
The people who come to me who have a 6 inch penis, it's easier for them to grow to 7, than it is for the fellow with a 3 inch erection to grow to a 4.
I wish it weren't so, but my suspicion is that with the muscles and with the penis the results involve many factors (some not so obvious). But, what appears plain is that when we’re talking about cellular growth, then the more you start with, the more easily you’ll see noticeable growth—because it’s a percentage results based on your baseline cellular mass when you start.
Nutrition & Growth
In addition to starting cell mass, other factors affecting growth include nutrition.
Poisons to Growth
Also, will the toxins from cigarette smoking be poisoning the new growth (why many surgeons won't do a face lift if the person smoked cigarettes with a week or two prior to surgery).
The same process that results in wound healing after surgery works as the way the penile tissue responds to the Priapus Shot® procedure—cellular growth & if the tissue struggles because of toxins, then it's not going to grow.
Method of Preparing & Injecting
Another factor that affects the results of the Priapus Shot® procedure is the method by which the procedure is done. Does the person doing the shot use equipment approved by the FDA for the preparation of PRP in a method that makes the PRP sterile enough to go back into the body and does the kit actually isolate an adequate concentration of PRP. Multiple attorneys work with us around the world to shut down physicians and non-physicians who claim to be doing the Priapus Shot® procedure but who do not understand the method of injecting or the method of preparing the PRP. You may think that’s a rare occurrence, but it’s not.
If you’re a physician or physician extender, you can apply to become one of our providers here (click)<—
Not only has is the platelet plasma made, but does the person understand where to put the plasma, how to inject it into the corpus cavernosum of the penis?
What’s Possible with the Priapus Shot® Procedure?
Somewhere around 60% of the people across the world, (around 70% in my practice) see growth of the penis that's a half an inch or more (that’s in circumference and in length).
I treated 2 men who swore they grew 2 inches in length and 2 inches in circumference. I saw quite a few who grew an inch to an inch and a half, but routinely, after the first procedure, you'll see a full half an inch in circumference and then another half an inch in length. The circumference appears first (within 2-3 weeks) and then the length appears after that (within 6-12 weeks).
Does it “work” every time? Can you guarantee results?
To understand how medicine works, consider antibiotics for people suffering with pneumonia in the hospital. That's a severe thing. One out of five of those people, 20% of people in the hospital with pneumonia die even on IV antibiotics, even with simultaneous dosing of our most strong, antibiotics-the infection kills them.
So, there's only an eight out of ten success rate with antibiotics for pneumonia in the hospital, but do antibiotics work?
Of course, they work! Just because 20% of the people who take them for pneumonia in the hospital still die from pneumonia doesn't mean that antibiotics don't work—they do work for 80% of people!
Should we quit using antibiotics for people because the antibiotics “don’t work” for some people? Are doctors tricking patients when they try to get people suffering with pneumonia well with antibiotics? Of course not!
But, sometimes I’ll get an email from someone who says the Priapus Shot didn't work! I was “ripped off!”
When I get emails like this, it makes me sad because I’m imagining a man who may suffer with sex & relationship problems and feel angry because he’s not yet well. I always want to help but because sexual function involves so many factors (with the penis, endocrine system, circulatory system, orgasm system, neurological system, psychology, social relations to his lover, & much more), there is no way for me to tell from an email or even a phone call what to do. All of these factors should be considered by the healer who is able to see the man on multiple occasions and to do a physical exam. He may even need a TEAM of providers to help guide him back to excellent physical and sexual health.
Some simple things to ask include the following:
Do you smoke ciagarettes?
Do you smoke pot?
Do you use narcotics for pain or recreation?
Do you take blood pressure medicine?
Is your testosterone too low?
Is your growth hormone too low?
Do you have a high estradiol level?
Is your prolactin too high? (In the recording, I erroneously say “too high.”)
Is your nutrition adequate?
Is your blood flow down because you're suffering with Type 2 diabetes and uncontrolled hyperglycemia?
There's so many things that can go on to explain why the Priapus Shot® “didn’t work.”
Also, why did you get the Priapus Shot? Was it for growth?
Was it for erectile dysfunction, Peyronie’s, lichen sclerosus, post op for prostate surgery, or to grow your penis in length or girth?
The success rate varies tremendously depending upon why you were treated and on all the cofactor discussed.
Do weight lifts work for muscle growth? Of course, they do, but some people lift weights their whole life and still never really get that strong or big. Others, they're genetically inclined to larger muscles and so they seemassive growth when they lift weights.
Your possibility for most strength and size of musculature happens if you do lift weights. If you want ultimate growth of your muscles, then you would lift weights.
What else might you do to grow bigger & stronger muscles?
You would use anabolic steroids!
Would Arnold look like Arnold if he weren't genetically endowed-an Austrian man with an excellent bone structure?
Would he look like Arnold if he never used anabolic steroids?
He very says that he used large doses of anabolic steroids. Back in his days of Mr. Olympia competitions, in the '70s, anabolic steroids were treated almost like antibiotics. Your pharmacist would just almost give them to you without a prescription.
They weren't controlled (like a narcotic) by the DEA until the 1990s.
Also, along those same lines, physicians did not think (in the formal medical literature) that bodybuilders were actually strong! They thought that the body builders just added “water weight.” Of course, they were stronger.
In the late 1980s, the medical research finally stated that the combination of weights plus anabolic steroids do make you stronger—much stronger! Your strongest self happens when you combine the two. Arnold because Arnold not because of genetics, because of anabolic steroid, or because of gut-wrenching, vomiting-because-of-effort workouts. He became Arnold & Mr Olympia 7 times because of all 3 of those combined!
If you talk to NFL players, they'll say, "Yeah, there's only two kinds of NFL players. Those who use anabolic steroids and those who lie about it." I don't know how true that is, but that's what I hear when I talk to NFL athletes.
Back to penis growth and a second question.
Do other methods work along with the Priapus Shot® and does the pump work alone?
Do weights work alone for muscles?
Yes, they do.
Do they work for everybody significantly?
No, they don't.
Do weights work better if you have growth hormones and steroids involved?
Yes, they do.
What's in platelet rich plasma?
One of the hormones in platelets is IGF-1 or somatomedin C, which is the active hormone we think that results from people who use growth hormone.
Growth hormone results in somatomedin C formation (also called insulin-like growth factor 1 or IGF-1) by the liver and other tissues.
That exact same growth factor (IGF-1) is released from platelets. When platelets are injected with a Priapus Shot® procedure.
Then, when you use the pump along with the Priapus Shot®, you're basically lifting weights and using steroids with your penis.
If the pump works, then how should I use it and for how long?
I have a link here (click) that takes you to a whole video and a whole transcript that gives you details about how to use the pump. There, I give you details that go along with research about how the pump works alone (without the Priapus Shot).
There you’ll find a paper showing growth with the pump alone—research published by the British Journal of Urology showing growth and straightening of the penis with a pump alone. In the study, men suffered with severe Peyronie's disease (enough that they planned surgery). Over half of them, canceled their surgery after 12 weeks of using a penis pump alone.
Physical techniques using the hands or traction, do they work?
Anything physical with the penis is going to “work” if performed intelligently. The problem with the hand is you can't as accurately judge what pressure you're applying (with the pump, you can use a pressure gauge). Risk for lack of efficacy and for significant side effects increase with inconsistent application of traction and pressure.
More significantly, in seeing thousands of men in my office, for every one person I've seen who increased the size of their penis by jelqing (which is another word for using your hand) or by using a traction device, I saw 50 men who reported to me that they saw a growth of their penis using a pump.
Use a pump (with your doctor’s supervision) and you use it the way I describe on the video (click).
What makes the penis growth from a pump?
How does the penis decide how big to be?
It's a physics problem—think of a water balloon.
A balloon (including the penis) stops growing when the pressure inside equals the combined pressure of the atmosphere outside and the tensile or stretch on the wall of the penis (a mathematical model for the collective connective tissue of the penis).
If you're using your pump regularly, it just makes sense, just like if you stretch out a balloon, it becomes easier to blow it up, but also because of the tensile strength of the wall becomes less, it equalizes at a greater size.
That's the physics of it. So first the tensile strength from the penis goes down. Then the Priapus Shot helps with repair and growth.
If you lift weights, then you repair, then you lift weights again, then you see growth of muscles. And, If you lift weights too much, there's damage.
You can use that same idea to grow the penis.
Some of the growth from the pump can also be edema. When you use the pump for a significant time (even at 10 or 15 minutes), you may see that fluid comes out of the intravascular space into the extravascular space (leaves the blood vessels to fill the tissue outside the blood vessels). You can even see this edema under the skin when your erection goes flaccid. There's no harm from the edema.
Sometimes, after weeks of using a penis pump, you might see some darkening of the skin of the penis. That color change tends to reverse if you stop pumping or quit pumping on a daily basis.
Any time there's significant growth of a physical biological structure (your finger, your hair, your face, your penis, your nose, whatever), for true growth, you must cause cell growth by either enlargement of the individual cells or by proliferation in the numbers of the cells.
That cellular growth happens in multiple other tissues: straightening bone or elongating bone, in some orthopedic injuries with traction devices & with soft tissues like the nose or the ears.
We know that the combination of physical therapies with hormonal or biological therapies affect the most significant growth (rather than either one alone).
And, we know that growth varies with multiple factors about which some of we know and about which some we continue to be completely ignorant.
I hope this is helpful. There is no 100% satisfaction with any procedure. What I can promise you is that the combination of all the factors that go in with health and with a healthy penis that are covered in my materials and those who are the other Priapus Shot® providers will be a good chance at your best penis.
Just like exercising and good nutrition and all that goes with the growth of the rest of your body— whether it’s growing muscles, or growing heart, or growing vasculature when you exercise— will achieve your best overall aerobic health and personal musculature strength, in the same way, following these therapies will achieve your best penis.
I wish you the best and I hope these ideas help you.
Peace & health,
Edited Transcript of the above Podcast about Penis Pumps...
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,
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.
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.
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.
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.
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.
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