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If you’ve ever witnessed someone suffer a stroke, you understand the humbling nature of this disease. It can reduce the mightiest human being to an immobile, helpless creature. Impairment of crucial functions like speech, walking, and control of bowel and bladder can wrench control from the body in a moment. Even perpetually youthful TV personality Dick Clark was struck down by stroke at age 75, despite the outward appearance of perfect health. Clark’s stroke resulted in a six-week hospital stay and, judging from fragmented reports, significant disability. Stroke can be like a devastating fire that strikes without warning, leaving only smoldering rubble. Stroke can so ravage basic bodily functions that often all you can hope for is to regain a portion through rehabilitation. The disease process that underlies stroke requires decades—30 or 40 years—to develop. With that much lead time, why aren’t we better able to detect or stop this crippling disease? The truth is that we are able to predict many, if not most, strokes. Advances in imaging technology allow detection of atherosclerotic plaque that cause stroke years before it becomes a threat. Progress in deciphering the causes of stroke has also leapt forward. Unfortunately, your neighborhood physician still focuses on diagnosing the crisis rather than anticipating it. Physicians prefer to deal with catastrophes and are just not that interested in prevention. Most physicians ask: “Is it time to operate or not?” The medical community obsesses over procedures like carotid endarterectomy (surgical removal of plaque) or carotid stents. Even when a person is afforded the warnings of a “mini-stroke”, or transient ischemic attack (TIA), little more is done once it’s determined that surgery is not necessary—even though this person has high risk for future stroke (50% over 10 years). Let’s flip-flop this approach to stroke. Procedures represent a failure of prevention! Where do strokes come from? Stroke develops when some portion of the brain is deprived of blood. This usually results from a tiny bit of debris that dislodges from an atherosclerotic plaque along the walls of an artery (the same sort that accumulates in coronaries causing heart attack). The sources of debris have been a subject of controversy, but new imaging technologies have settled the question. Any blood vessel that leads from the heart to the brain can be a source. The two carotid arteries on both sides of your neck are a frequent source, as these arteries are prone to develop plaque. (Our discussion will be confined to what are called thromboembolic, or ischemic, strokes, i.e, strokes that occur from plaque that fragments, sending debris to the brain, and will not include the far less common hemorrhagic strokes due to rupture of small vessels in the brain, nor will we discuss atrial fibrillation and other heart causes of stroke. The thromboembolic strokes we discuss cause around 88% of all strokes.) Over the last 10 years, the aorta has been recognized as another important source of stroke. The aorta is the main artery of the body whose branches go to the head, arms, and legs. Atherosclerotic plaque is a live tissue that, through poor diet, inactivity, high cholesterol, overweight, etc., grows and becomes progressively more unstable. At some point, plaque fragments. Little bits break away, traveling to the brain. Fractured plaque also exposes its deeper structures to flowing blood, triggering blood clot formation, which in turn can also fragment and go to the brain. Atherosclerotic plaque is a prerequisite for the most common causes of stroke. If the majority of strokes originate from plaque, why not measure plaque to determine if you’re at risk for stroke? How can we easily, safely, and accurately measure plaque in the carotid arteries and aorta? And if plaque can be measured, can it be shrunk or inactivated to reduce or eliminate risk for stroke? How can plaque be measured? Just 20 years ago, the only practical method of identifying plaque in the carotids or aorta was through angiography, requiring catheters inserted into the body to inject x-ray dye. Angiography was impractical as a screening measure. CT scanning and magnetic resonance imaging (MRI) are emerging as exciting methods of imaging both carotids and aorta. Unfortunately, most centers and physicians are much more focused on the diagnostic uses of these technologies for people who have already suffered stroke or other catastrophe, and application of these devices for preventive uses is still evolving. One exception is when aortic calcification or aortic enlargement is incidentally noted on the increasingly popular CT heart scans; this is an important finding that can signal presence of aortic plaque. The one test that is widely available and can be performed in just about any center is carotid ultrasound. It’s simple, painless, and precise. Two basic observations can be made: 1. Plaque detection—Atherosclerotic plaque can be clearly visualized. If plaque blocks more than 70% of the diameter of the vessel, or if there are “soft” (unstable) elements in plaque, then stroke risk may be high enough to justify surgery or stents. However, if there are plaques that are less severe, substantial risk for stroke may still be present that can be reduced with preventive measures. 2. Carotid intimal-medial thickness—This is a measure of the thickness of the lining of the carotid artery in areas not involved by plaque, but often precedes the development of mature plaque. Carotid intimal-medial thickness also provides an index of body-wide potential for atherosclerotic plaque that can place you at risk for stroke. The aorta, for instance, cannot be well imaged by surface ultrasound but can still be a source for stroke. Increased carotid intimal-medial thickness and carotid plaque are closely associated with likelihood of aortic plaque. The Rotterdam Study of 4000 participants demonstrated that if carotid intimal-medial thickness is greater than normal (1.0 mm), then you can be at risk for stroke (and heart attack), even if no carotid plaques are detected. Carotid ultrasound is the one test you should consider that provides the most information with least effort. Ultrasound is harmless, painless, and can be obtained just about anywhere. Even if your doctor disagrees with your request for a carotid ultrasound, an increasing number of mobile services are popping up nationwide that make this test available for around $100. One important point: many scanners and interpreters will only report whether plaque is present or not. While this is important information, you should request that the carotid-intimal medial thickness be made as well. Not all centers can make this simple measure (because of software requirements), but it doesn’t hurt to try. Any amount of carotid plaque is reason to follow a preventive program, even if the plaque is insufficient to justify surgery. Can plaque be reduced? Can we shrink plaque in carotid arteries and aorta and thereby reduce, perhaps eliminate, these sources of stroke? That question is gaining momentum as effective therapies become available that pack real punch for reducing plaque. Study after study has now documented that plaque can be reduced and, with it, risk for stroke. Reduction in plaque of 10–20% is possible within a year or two. Let’s consider the most potent influences on carotid and aortic plaque growth that need to be considered in a plaque-reducing program. (I assume that you are a non-smoker—if you are a smoker, you first need to concentrate on quitting.) Hypertension Considerable experience documents the power of blood pressure-lowering for prevention of stroke. The most recently updated guidelines, the JNC–VII, recommends a blood pressure of 407 mg/dl heightens stroke risk six-fold. C-reactive protein (CRP) This measure of inflammation is proving to be a useful marker for identifying people at risk for stroke, with increased risk beginning at a level of 0.5 mg/l. High CRP also predicts more rapidly growing carotid plaque. Homocysteine Homocysteine is an important marker of increased likelihood of both carotid and aortic plaque, as well as stroke. In 1997, the European Concerted Action Project reported more than a doubling of stroke when homocysteine levels exceeded 12 mol/l. As homocysteine increases to 20 μmol/l, risk for stroke and heart attack increases an amazing 10-fold over that at a level of 9 μmol/l. Asymmetric dimethylarginine (ADMA) ADMA is recently discovered amino acid whose blood levels can skyrocket up to 10-fold in the presence of hypertension, metabolic syndrome, diabetes, high cholesterol and triglycerides, obesity, and high homocysteine levels. ADMA blocks the action of the amino acid, l-arginine. This mimicry reduces the availability of nitric oxide, a powerful dilator and protector of arteries. ADMA levels in the top 10% predict a six-fold heightened risk for future stroke, and ADMA levels in people with strokes are double that in other people. A carotid ultrasound study in 116 subjects showed that higher blood levels of ADMA are associated with more severe carotid plaque. Because of ADMA’s shared role across a variety of abnormal conditions, correction or blocking the action of ADMA has been suggested as a unique therapeutic tool to reduce stroke risk. Cholesterol Data suggest that lowering cholesterol with statin cholesterol-lowering drugs slows carotid plaque growth and reduce stroke risk approximately 22%. An interesting study from the Cardiovascular Institute at Mt. Sinai School of Medicine in New York using the precise measuring ability of MRI of the carotids and thoracic aorta showed an impressive 20% regression of plaque area with simvastatin (Zocor®) taken for two years. Although guidelines for cholesterol treatment recommend reduction of LDL cholesterol to 100 mg/dl in high-risk persons, a report from the Walter Reed Army Medical Center in Washington, DC, showed that carotid plaque was more effectively reduced when LDL cholesterol of 70 mg/dl or lower was achieved with statin cholesterol drugs. Lower LDL cholesterol may, therefore, be better. Treatment Strategies to Reduce Carotid and Aortic Plaque The essential question: How do we reduce carotid and aortic plaque? If we make this the focus of our efforts, many pieces begin to fall into place. If you’ve had any measure of carotid or aortic plaque such as a carotid ultrasound or aortic calcification on a CT heart scan, you know that you’re at increased risk for stroke. You also have a baseline for future comparison to gauge whether your program is working or not. Because most people have not one but several causes of carotid and aortic plaque, there is no one single treatment that effectively eliminates risk for stroke. Instead, most people require a comprehensive program of healthy diet, exercise, supplements, and medication when indicated. Here, we focus on the nutritional supplements that can be critical components of your plaque-reduction program. Fish oil Fish oil is a cornerstone of your stroke prevention program. Epidemiological observations suggest a strong relationship of fish intake and reduction of stroke risk. Carotid ultrasound studies demonstrate less carotid plaque with greater intakes of fish. A cleverly designed University of Southampton study made the fascinating observation that fish oil transforms the structure of carotid plaque. 150 people with severe carotid plaque scheduled for carotid endarterectomy (surgical removal of the plaque) were given fish oil, sunflower oil, or no treatment over several months while waiting for their procedure. (Delays in the British health system permitted this unique design.) Plaque was removed at surgery and examined. Participants taking fish oil had reduced inflammation in plaque and thicker tissue covering the fatty core, markers of more stable plaque. Those taking sunflower oil or no treatment had unstable plaques with greater inflammation and thinner, less sturdy covering tissue. This suggests that fish oil stabilizes carotid plaque, making it less likely to rupture and fragment. A standard capsule of fish oil (containing 300 mg of EPA + DHA) contains the same amount of omega-3s as a 3 oz serving of cod or halibut; three capsules (900 mg DHA + EPA) contain the equivalent of a serving of farm-raised salmon. The dose that seems to provide greatest protection from stroke, lowers triglycerides (that form abnormal lipoproteins; see above), and reduces fibrinogen, is four capsules per day (1200 mg EPA + DHA). Coenzyme Q10 (CoQ10) Although there are no data specifically addressing whether CoQ10 reduces plaque, it is a marvelously effective way to reduce blood pressure, one of the crucial factors causing carotid and aortic plaque growth. A pooled analysis of eight studies showed that, on average, CoQ10 in daily doses of 50–200 mg reduced systolic blood pressure by 16 mm Hg, diastolic pressure by 10 mm Hg. Data suggest that CoQ10 can reverse abnormal heart muscle thickening (hypertrophy), another manifestation of high blood pressure, strongly suggesting that CoQ10 has benefits beyond just reducing pressure. Supplements to correct the metabolic syndrome Weight loss is, without question, the most immediate and direct path to correction of this dangerous pre-diabetic condition. A drop of even 10–20 lbs yields improvements across the board: increased sensitivity to insulin, increased HDL, and reductions in triglycerides, CRP, fibrinogen, small LDL particles, and blood pressure. Diet and exercise are fundamental components of an effort to lose weight; low carbohydrate or reduced glycemic index diets (e.g., South Beach or Mediterranean) rich in fibers are clearly effective. Several supplements can amplify weight-reduction efforts and be useful adjuncts to your lifestyle program. Among them: White bean extract White bean extract blocks intestinal absorption of carbohydrates by 66%. 1500 mg twice a day with meals yields, on average, 3–7 lbs of weight loss in the first month of use. The only side-effect is excessive gas, due to unabsorbed starches. Glucomannan This unique fiber taken prior to meals absorbs many times its weight in water and thereby fills your stomach. You consequently take in less food. Most people lose around four lbs per month using 1500 mg prior to each meal. Interestingly, glucomannan also blunts the rise in blood sugar after meals, an effect that, by itself, may lead to weight loss. Be sure to take with plenty of water. DHEA This adrenal hormone is key to maintaining physical stamina, mood, muscle mass in men, and libido in women. A recent randomized, placebo-controlled study at Washington University in 56 subjects showed a 13% decline in abdominal fat (fat that drives resistance to insulin) measured by MRI with 50 mg of DHEA per day at bedtime, along with improved sugar control and lower insulin levels. Pectin, beta-glucan Pectin is the soluble fiber in citrus rinds, green vegetables, and apples, also available as a supplement. Beta-glucan is the soluble fiber of oats and is also available as a supplement. Both are wonderful fibers that provide feelings of fullness, lower cholesterol, slow release of sugars, and can yield modest weight reduction. A USC study in 573 subjects using carotid ultrasound showed that greater intake of healthy fibers like pectin and beta-glucan is associated with less carotid plaque growth. Folic acid, vitamins B6 and B12 Dr. Daniel Hackam at the Stroke Prevention and Atherosclerosis Research Centre in Ontario conducted a study using carotid ultrasound in 101 participants treated with folic acid 2.5 mg, vitamin B6 25 mg, and B12 250 mcg per day. Treatment resulted in plaque reduction, especially when homocysteine levels exceeded 14μmol/l at the start, compared to untreated participants who experienced substantial plaque growth. An attempt to clarify the role of homocysteine treatment was made through a National Institute of Health-sponsored study of stroke prevention. 3680 participants with a prior history of stroke were enrolled and given either a “low-dose” (20 mcg folic acid, 0.2 mg B6, 6 mcg B12) or a “high-dose” (2.5 mg folic acid, 25 mg B6, 400 mcg B12) regimen. Although starting homocysteine levels showed a graded association with stroke risk (higher homocysteine levels predicted greater stroke risk), the treatment groups experienced, on average, only a 2 μmol drop in homocysteine levels and no reduction in stroke risk over two years. The study investigators as well as critics have suggested that the study failed due to an insufficient treatment period and that the doses were too low. (The doses we use in our plaque reduction program are folic acid 2.5–5.0 mg, B6 50–100 mg, B12 1000–2500 mcg.) L-arginine L-arginine can be used to overpower the adverse effects of ADMA. L-arginine is emerging as an important carotid plaque-reversing tool. Early reports in animals showed that l-arginine completely halted growth of aortic plaque, and did so more effectively than lovastatin (a cholesterol-lowering drug). In humans, L-arginine reduces blood pressure, abnormal constriction of carotid and coronary arteries, blocks entry of inflammatory cells into plaque, increases sensitivity to insulin, and heightens exercise capacity. Following coronary angioplasty or stent placement, l-arginine results in up to 36% reduction in plaque growth. The average American takes in 5400 mg of l-arginine through food every day. Supplementing with doses of 3000–12,000 mg per day has proven useful to correct many of these phenomena. (We use a dose of 6000 mg of l-arginine powder, twice a day on an empty stomach, dissolved in water, for our plaque regression program.) Does this result in a reduction of stroke risk? The emerging data suggest that l-arginine is likely to exert a powerful plaque-reducing and stroke-preventing benefit, but we await more clinical trial data. Conclusion Reducing stroke risk by reversing carotid and aortic plaque is becoming an everyday reality, with better tools becoming available. To know whether you’re at risk, the best and most available imaging tool is carotid ultrasound, aiming to identify intimal-medial thickness >1.0 mm, or carotid plaque. Any degree of calcification of the aorta, such as on a CT heart scan, is another useful measure of risk. Treatment to reduce risk is multi-faceted but is based on examining all your sources of risk, including metabolic syndrome, small LDL, lipoprotein(a), and C-reactive protein. Fish oil is the one absolutely crucial ingredient in any stroke prevention program. Other supplements can be used in a targeted fashion, depending on the causes identified for your carotid or aortic plaque. Ideally, repeat scanning of your carotids should be done sometime after your program has begun to assess whether you’ve successfully achieved reversal of plaque growth. penile enlargement excersizes vigrx for men truth about penis enlargement pill truth about penis enhancement penis enlargment surgery compare penis enlargment pills safe penile enlargment penis enargement doctor permanent penis enlargement
By understanding the 4-phase arousal process you can put an end to your premature ejaculation frustration. During this process, your body goes through a number of physiological changes which form a definite, typical pattern. In the simplest terms, this pattern can be described as a build-up and release of tension. Phase 1. Excitement Premature Ejaculation can be set off due to over excitement. This is when you start to feel the onset of arousal. This phase can be brought on by physical contact, your thoughts and your emotions. In the excitement phase your breathing deepens and heart rate increases. You experience increased muscular tension and a rise in blood pressure along with the beginnings of an erection. As the level of arousal rises, there is a resultant increase in muscular tension, pulse rate and blood pressure. Some men have what is known as a 'sex flush' which is a red rash beginning in the lower abdomen and then spreading to the neck and face or even to the shoulders, arms, and thighs. Phase 2. Plateau The word 'plateau' identifies that a certain level of arousal and excitement has been reached. Your erection is full and you feel highly aroused. This is maintained for a period of time before orgasm takes place. This is a difficult stage as the premature ejaculation signs are building up. Although the fully erect penis does not go through any major changes in this phase, your testes will swell and draw closer to the abdomen. During plateau, the bulbourethral gland (or Cowper's gland) emits a clear, viscous liquid known as 'pre-ejaculate' or 'pre-cum'. This purpose of pre-cum is to lubricate the female urethra for sperm to pass through. It also flushes out any residual urine or foreign matter. As a cautionary side note; pre-ejaculate can contain sperm and therefore cause pregnancy (I was amazed how many men I spoke to who did not know this while I was researching premature ejaculation). Phase 3. Orgasm An orgasm is also known as the sexual climax and occurs in response to continued sexual stimulation during the plateau phase. Prior to orgasm there is immense tension in the muscles throughout the body. Breathing is rapid while pulse rate and blood pressure are more elevated than during plateau. It is an abrupt, reflex release from this 'whole body' tension that forms the orgasm. It is the most intensely pleasurable of all the phases and also the shortest, (and for those with serious premature ejaculation problems, even shorter!). It can be physical, psychological, emotional, or a combination of these. It is often accompanied by an obvious physiological response, such as ejaculation, blushing or spasm. Either during sex or while masturbating and the feeling of orgasm is imminent, men find it difficult to stop the stimulation of the penis to the point of ejaculation because the feeling is so intensely pleasurable and satisfying. Phase 4. Resolution This is phase where your body returns to the former pre aroused state. After orgasm your whole body (and in particular your sex organs) require time to return to the former, un-aroused state. The most observable change in this period is the loss of erection. During this phase and immediately after orgasm, men experience what is known as the "refractory period" and are physically unable to have another orgasm. The length of time of the refractory period is different for everyone. Times ranging from ten minutes to several hours are common. There may also be such a refractory period in females, although it is much shorter and many women can experience several orgasms in rapid succession. Gaining an understanding of this 4 step process will get you in the right direction when looking for a premature ejaculation cure. enlargment manhattan penis natural penile enlargment technique penis enargement system does penile enlargment work penile enlargement system penis enhancement without pills penis enlagement pills compare pnis enlargement pills permanent penis enlargement
Okay here's a subject that really gets my blood boiling. Bodybuilding is intended to be the creation of the perfect physique...right? That means that the chest, shoulders, legs, arms and back are suppose to be developed to their full potential while keeping the waist muscular but small. Some bodybuilders may have one genetically gifted part that has a tendency to be superior to another part. The normal goal is to emphasize the training of the weaker body part while curtailing training to the more responsive body part. This is done to obtain proportional muscle size. In achieving the perfect physique, the waist is meant to be small compared to upper body parts and the legs. The smaller the waist the more dramatic the surrounding muscles appear. The Back will look like a flared cobra's head when attached to a tiny waist. I remember the physiques of the past, Arnold, Bob Birdsong, Franco Columbo, Bob Paris and Frank Zane achieved this dynamic look. Darin Lannaghan, Bill Davey and Stan McQuay have produced this look in modern day bodybuilding though they may never be seen at the Arnold Classic Competition. So What's Changed? In mid 80's, Human Growth Hormone (HGH) and Insulin became popular drugs with professional bodybuilders. The net result, with these top level competitors, is the "Roid Gut". Now days, we have bodybuilders sporting a 40-46" waists. I am guessing, of course, since no competitor would dare share the mammoth size of their waistlines. If they did, I would bet they would shave the number down an inch or two. Unfortunately, the Roid Gut has a repulsive appearance contrary to the original intent of the sport. When Jay Cutler in his early years hit national prominence, his youthful physique still had the small waist. Today, Jay's waist is absolutely gross. Sure he may weighs 270+ lbs, but also he sports a waist line of a sumo wrestler. Most of the top bodybuilders, Ronnie Coleman, Dorian Yates and Craig Titus, all exhibit this similar phenomenon. These competitors are simply meeting the expectation of what the judges are condoning and encouraging by accepting this look at as the "champion" physique. I am writing this article to discourage the use of these drugs. They are sucking the lifeblood out of the Sport, destroying the potential aesthetics of the physique, and taking the bodybuilding back to the freak show era of the past. THIS SHOULD NOT BE! HGH, "Huge Gut Hormone?" Okay so what does HGH do to the body? In a normal person, HGH is produced by the body and causes the normal body growth process. The HGH drug was originally developed for children that exhibited stunted growth and were found to have a low production of this hormone. Doctors would administer HGH in small amounts to stimulate a normal growth pattern. In a few people, HGH production is overactive (from birth) it can also create person of gigantic proportions. Andre the Giant had this condition. Robert Wadlow was another and he grew to be 7'11". He had many health problems and died at a very early age. If HGH is administered to an adult, muscle growth restarts. HGH is very different than steroids. HGH causes production of new cells. Steroids cause only the enlargement of existing cells. The new cell growth seems to target only with the soft tissues and rarely skeletal system. Unfortunately, not only are the muscles cells multiplying but so are the internal muscles like the intestines and heart. Furthermore, organs, like the liver, kidneys and pancreas are growing too. When the growth of these internal muscles and organs occur in a fixed chest cavity, there is only one direction for this extra mass to go and that is out the abdominal area. Starting to get the picture? Insulin's Additive Affect Now what is insulin's affect on the body? Insulin is a super steroid that funnels the nutrients and sugar into muscle. When combined with hard workouts, recovery is very quick. Properly taken, it drives cell growth better than any other steroid. However if you screw up in taking insulin at the wrong time or dosage, you can throw yourself into insulin shock and die. Also long term use can make you a diabetic, a condition that shortens life. When Insulin is combined with HGH, the muscles are set to make significant gains. The downside of insulin is that it is also active in creating the storage of fat in the body in the event of starvation. These fat deposits are stored internally to body and not on the exterior muscles. This is wonderful for the bodybuilder's appearance but not for this health. These fat deposits called visceral fat are found around the internal organs of the liver, pancreas, heart and kidneys. Couple this additional weight with growth of the internal muscles and organs and you have enough extra mass to create a really protruding Roid Gut. "Side Bar" Story Let me tell you one story that comes to mind back in the very early 80's. Tim Belknap, then a great in the world of bodybuilding, announced that he was diabetic. I have no reason to doubt he was, but I am now convinced that Tim found the secret to using insulin to maximize his bodybuilding potential. During that era, Tim was by far the most vascular bodybuilder on the scene. I also notice, he had a semi-protruding waistline. At the time I felt sorry for Tim being handicapped with diabetes but admired that he had accomplish a world class physique under this condition. Now looking back, I am sure Tim was able to apply his insulin to his bodybuilding benefit. You be the Judge I am convinced that these "super heavy weight" competitors at 270+ lbs might really weigh 240 or so if you stripped the mass out of their guts. But then again they might only weigh 220 if they lost the additional muscularity as a result of these two drugs. Let's return to the aesthetic builds of a few years past. I hope that even if judges don't award the small waist competitor the winning trophy, you will agree, that creating a Roid Gut is neither attractive nor healthy!