Tweeti would go 50 mg ed i have to use 100 mg ed myself
Tweeti was gonna run proviron with my t3,clen, M1test... mainly to harden up, and would continue it after as my pct..
what would i need to run it at... 25mg/ed or 50 ?
Tweeti would go 50 mg ed i have to use 100 mg ed myself
Tweeti am considering running 25mgs a day until summer to get real hard
TweetJust some info on Priapism from:Originally posted by pigmeat
Some get perma hardons.
Martin J Carey, MD, MPH, BCh, Program Director, Assistant Professor, Department of Emergency Medicine, University of Arkansas for Medical Sciences
Background: Priapism is the presence of a persistent, usually painful, erection of the penis. Although frequently idiopathic, priapism is associated with some systemic diseases. Priapism also is associated with the use of intracavernosal injections of medications to treat impotence.
Pathophysiology: Priapism is a persistent erection of the corpora cavernosa of the penis, originating from disturbances to the mechanisms that control penile detumescence. This process affects only the corpora cavernosa. The corpora spongiosum of the glans penis and surrounding the urethra remain flaccid.
Two types of priapism are described. Arterial high-flow priapism usually is secondary to a rupture of a cavernous artery and unregulated flow into the lacunar spaces. This type of priapism is usually not painful. Veno-occlusive priapism is usually due to full and unremitting corporeal veno-occlusion. Prolonged veno-occlusive priapism results in fibrosis of the penis and a loss of the ability to achieve an erection. Significant changes at the cellular level are noted within 24 hours in veno-occlusive priapism, whereas arterial priapism is not associated with fibrotic change.
Frequency:
In the US: Arterial high-flow priapism is a rare entity and is usually secondary to penetrating penile trauma or a blunt perineal injury. Patients with sickle cell disease are prone to veno-occlusive priapism. In one study, 38-42% of patients with sickle cell disease reported at least one episode of priapism.
Mortality/Morbidity:
Deaths have been reported in patients with sickle cell disease presenting with priapism, but cause of death usually is not related to the priapism per se but to complications from the underlying disease process.
Morbidity is related to long-term impotence, primarily with veno-occlusive priapism, when diagnosis and therapy have been delayed.
Sex: Priapism is primarily a disease of males. Priapism of the clitoris has been described very rarely.
Age:
Priapism has been described at nearly all ages, from infancy through old age.
In patients with sickle cell disease, the peak incidence seems to occur in persons aged 19-21 years.
History:
Arterial high-flow priapism
Onset of priapism may be delayed after the acute injury. The delay may be due to vessel spasm initially or to the formation of a clot that is gradually reabsorbed over a period of days.
Priapism secondary to arterial causes usually is less tumescent when compared with venous priapism.
Priapism secondary to arterial causes also may be significantly less painful than venous priapism.
Veno-occlusive priapism
Patients with veno-occlusive priapism present with a painful erection.
Erection may have been present for hours to days.
History should include a detailed past medical history and a detailed drug history, including therapeutic and illicit drugs.
Physical:
Presence of priapism should be confirmed by the finding of an erect or semierect penis, with a flaccid glans penis.
Carefully examine for evidence of trauma to the genital region.
Examine the patient for evidence of intercurrent problems that may predispose to priapism.
Causes:
Some patients may use chemical agents to induce an erection. In these patients, excessive use may produce priapism. Examples of agents used to induce an erection include papaverine, phentolamine, and prostaglandin E1.
Veno-occlusive priapism most commonly is idiopathic.
Other causes
Leukemia and multiple myeloma
Sickle cell disease and thalassemia
Tumor infiltration
Spinal cord injury and spinal anesthesia
Fabry disease (rare association, occasionally noted to be priapism of the high-flow type)
Recent infection with mycoplasma pneumonia (Mechanism is thought to be a hypercoagulable state induced by the infection.)
Amyloidosis
Carbon monoxide poisoning
Malaria
Black widow spider bites
Drugs
Many psychotropic medications, especially chlorpromazine, trazodone, and thioridazine: The newer agents are not immune to this complication. Priapism has been described with citalopram, a selective serotonin reuptake inhibitor.
Hydralazine, metoclopramide, omeprazole, and hydroxyzine
Prazosin, especially when used in patients with renal failure
Tamoxifen, testosterone
Calcium channel blockers, anticoagulants, both warfarin-induced and during heparin infusions
Cocaine, marijuana, and ethanol abuse: Recently, the complication has been described in patients using ecstasy. Priapism has also been described in persons using androstenedione for athletic related purposes.
Lab Studies:
In patients with no known predisposing factors, a complete blood count (CBC) is appropriate in order to identify the rare case of priapism associated with leukemia.
Patients with sickle cell disease should have a CBC and a reticulocyte count.
Coagulation profile
Platelet count
Urinalysis
Prehospital Care:
Any patient who has an erection for longer than 4 hours, especially if they have a predisposing illness (eg, sickle cell disease) probably should receive therapy for priapism. Most cases, if seen early enough in their course, respond to conservative measures.
Examples of immediate treatment that can be suggested prior to arrival at the hospital may include the use of ice packs to the perineum and penis or asking the patient to walk up stairs.
The mechanism for the latter strategy is thought to be an arterial steal phenomenon.
If these measures fail to produce rapid detumescence, patients should not delay transfer to the hospital.
Emergency Department Care:
Use of prolonged external perineal compression, including ice, is frequently unsuccessful but may be a temporizing measure in the ED or in the prehospital setting.
Pharmacological interventions include the use of alpha-agonists (eg, metaraminol bitartrate) or methylene blue. Alpha-agonist agents counteract smooth muscle relaxation. However, they may cause significant systemic hypertension. Methylene blue inhibits guanylate cyclase and has a second messenger inhibitory effect; thus, it inhibits smooth muscle relaxation. The effect of methylene blue is relatively short-lived, and priapism may recur.
Ligation of the fistula may be required. However, potential complications of this procedure include long-term impotence.
Selective embolization is a relatively new approach, which has been shown to be effective with few long-term complications in some studies. Patients who do not respond to more conservative measures may benefit from this approach.
Some studies suggest that the use of terbutaline orally, at a dose of 5 mg, followed by another 5 mg 15 minutes later, if required, produces resolution in about one third of patients. This may be a reasonable treatment option while preparing the infusion. If no resolution occurs within 30 minutes, injection therapy is required.
Intracavernous injection of an alpha-adrenergic agonist can reverse the vascular effects of phentolamine or papaverine rapidly. Phenylephrine is the most selective and potent alpha1-adrenergic vasoconstrictor. It has a rapid onset of action at less than 1 minute, and its duration of action is 7-20 minutes. As phenylephrine has no clinically significant beta-adrenergic receptor activity, it is unlikely to produce systemic cardiovascular toxicity after intracavernous injection.
The dose is 100-500 mcg per dose, up to 10 doses. The drug is best administered in a dilute solution. Add 10 mg (usually 1.0 mL) of phenylephrine to 499 mL of saline 0.9%. This yields a solution with 20 mcg/mL. Use 10-20 mL of this solution via intracavernous injection every 5-10 minutes.
The needle should be inserted into the penis laterally in order to avoid the urethra ventrally and the neurovascular bundle dorsally.
Perform a penile nerve block, injecting around the base of the penile shaft with 1% plain lidocaine.
After anesthesia is assured, use a 19-gauge needle attached to a large syringe and puncture the corpus cavernosum. This should be done through the shaft of the penis, not through the corpus spongiosum.
The aspiration site should be at the 2-o'clock or the 10-o'clock position.
Initially, 20-30 mL of blood should be aspirated.
Milking the shaft of the penis in order to empty the corpora may be necessary.
As there are multiple communications from one corpus to the other, aspiration usually is required only at one or other site.
After detumescence is obtained, the penis should be dressed with an elasticized bandage to ensure continued emptying of the corpora and to compress the puncture site.
If this procedure is not successful, repeat aspiration, with the instillation of an equal volume of a solution of phenylephrine (10 mg phenylephrine in 500 mL of 0.9% saline).
Note the contraindications listed for the use of phenylephrine in the Medications section.
If aspiration of the corpus cavernosum reveals bright red blood initially rather than the dark blood expected, this represents high-flow priapism. Consider an arterial cause for priapism and institute the steps noted above.
Surgical procedures may be required if conservative measures or the infusion of phenylephrine fail to produce detumescence.
Therapy for priapism secondary to sickle cell disease includes hydration, alkalization, analgesia, and hypertransfusion and/or exchange transfusions to increase hemoglobin concentration to higher than 10% and decrease hemoglobin S to less than 30%. Red cell transfusion may be required.
Use of alpha-adrenergic agents intracorporeally may be required if conservative measures fail.
Patients rarely have been reported to develop neurological symptoms, including headache, seizures, bradycardia, apnea, and coma, during exchange transfusions or hyper-transfusions. Intubation may be required in these cases. ED physicians should be aware of the possibility of these problems developing and be ready to manage them.
Some centers are experimenting with the use of hyperbaric oxygen for this complication.
Consultations: Failure to resolve the priapism in the ED mandates emergent referral to a urologist.
Hussle Man
"The Most Incredible Baby"
hussle-man@hushmail.com
Tweetdo you use it as an anti E or for its hardening and hardening properties..
Originally posted by jipped genes
i just run 25mg and it does fine
TweetThat’s exactly why I don’t use it. Permanent wood might sound good, but it’s not.Originally posted by pigmeat
dont run too much. Some get perma hardons. Try 50mg and see how it works.
TweetOriginally posted by Drenten
That’s exactly why I don’t use it. Permanent wood might sound good, but it’s not.
i've never used prov. is it really that strong>?
rip gu
"I tell the truth...even when i lie"-scarface
TweetWell, it’s not so much that it’s strong, it’s just that permanent wood is a possible side effect. It doesn’t happen to everybody.Originally posted by NeverSatisfied
i've never used prov. is it really that strong>?