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Heart disease is the big killer in the US. According to the American Heart Association and the Centers for Disease Control and Prevention, while the overall death rate is falling slightly (sorry, all that means is people are living longer), the leading cause of death is cardiovascular disease. Put into numbers, it carries off about one-third of us every year. And this is despite all those wonderful drugs to treat high blood pressure, lower those cholesterol levels and keep the heart beating at a steady pace (that’s before they plug in one of those battery-driven pacemakers). However you try and square the circle, we are killing our hearts by refusing to quit smoking, eating too many fatty foods and refusing to exercise. So why drag all these depressing facts in here? Well, the good news for all men is a little known biological fact.

The first symptom of heart disease is a hardening of the arteries. This disease is called atherosclerosis. With high levels of cholesterol in the blood, you get a slow deposit of platelets on the walls of the blood vessels. These harden and gradually obstruct the flow of blood. They also prevent the muscle walls from dilating and contracting. In the early years, the only sign may be a slight increase in blood pressure. But here we come to our little known fact. The artery feeding blood into the penis is one of the smallest in the male body. Who would have thought it. All that blood flowing into the penis to make the erection hard, yet flowing through the smallest artery in the body.

That means the first clear symptom of atherosclerosis is going to be erectile dysfunction. If the muscles walls of the penile artery do not dilate and only permit a slow flow of blood into the penis, any erection that forms is going to be soft. That means you will immediately be treated as a potential heart patient every time you walk into a doctor’s surgery and admit erectile dysfunction. The figures actually show erectile dysfunction appears between two and five years before a stroke or “cardiac event” – a wonderful phrase meaning your heart stopped beating or beat in a way that prevented the blood from supplying oxygen where it was needed. Read the rest of this entry »

When you start talking about China, you immediate run into massive numbers. It’s hard to imagine it, but the country is edging up to 1.4 billion people. And that’s despite the one-child policy. You remember that. After WWII, the Chinese thought a big population was a good thing but, when the Government saw how difficult it was to feed everyone, they decided big was no longer beautiful and enforced a law limiting each family to one child. This has produced two interesting outcomes. Couples forgot to register the birth of girls, but were proud to announce the arrival of a boy. This has produced an unbalanced population with about 4% more men than women. Many aging families now have no filial children to look after them. Perhaps more importantly, despite the abandonment of the policy, modern couples are no longer planning families. That’s allowing for the fact that, with a shortage of women, there are fewer couples anyway.

Why should this matter? Well, as time passes and the population ages, there will be fewer people around to produce the children to keep China going. Then along comes even more exciting news. According to a research project undertaken by Peking University People’s Hospital, slightly more than 25% of Chinese men currently suffer from erectile dysfunction. OK let’s put this in context. Allowing for a reasonable proportion of these men not being in relationships, or being too old to have children, that’s millions of men who are unable to get their wives pregnant. Now put aside all the old Cold War thinking that, if the US just sits still, China will collapse during the next century and the US will maintain its supremacy. If society begins to break down, there’s no guarantee this will be a peaceful process. Anyway, by the time the Chinese demographic time bomb strikes, the US will be controlled by the majority Latino, Asian and African American population. Their foreign policy may be rather different to the current caucasian view of the world. As an aside, we should note the current birth rate among the white population is falling rapidly with some 18% of adult US males reporting erectile dysfunction. Read the rest of this entry »

Some people are driven because they are so good, they can earn a living playing sport, dancing or in some other profession based on the ability to move in particular ways. Others are just driven. They know they will never be a top player, but they always want to do the best they can. Whatever the motive, there’s a constant cycle of practice and rehearsal. You can see these people in the gyms and endlessly working through routines to improve their strength or swing, to build up power in the hips and knees, etc. Whatever the required skill, there are repetitive exercises to groove the movement until it becomes an automatic, unthinking response when playing or performing. Except there’s a danger. It’s called an overuse injury. The more you use the same muscle groups, the greater the risk of muscle fatigue and injury. Ask any racquet player or a pitcher about tendonitis in the elbow and you will see the constant fear of an injury that could cut short a career.

In the merely good player, psychological adjustments can be made. It will be painful to take a long rest or, in the worst cases, to stop playing altogether. But it’s not the end of the world – well not completely the end of the world. In the younger player, it can be devastating. Take someone in high school. They are being groomed for the professional ranks. Perhaps this will take them through university on a sports scholarship. Either way, an injury is going to derail the future. Suppose you have a young pitcher. Scouts have already seen him play. Nods of approval have been exchanged. Then tendonitis strikes. In a perfect world, he would take at least a month off. And even when the doctor approves the resumption of training, this would be light and there would be no pitching at full power until the recovery was complete. Except that’s not how it works. To give himself the best chance of being in the first draft or in that scholarship program, he needs results. So, after a week or so, he’s back pitching. He plays through the pain for the greater gain. But there’s a risk. He can fracture his elbow. It’s the same with basketball and volleyball injuries to the knees. Why does this happen? Because, in younger players, the muscles can be stronger than the immature bones. If teens try too hard, they can literally break their bones. Read the rest of this entry »

The standard approach to the use of muscle relaxants is to use them for the treatment of acute, i.e. short-term, injuries. The idea is to reinforce the need for a complete rest by relying on the sedative qualities of muscle relaxants. This gives the body a chance to begin healing. Then, with physical therapy, you can slowly restore strength and mobility. Because it’s not safe to use these drugs over any significant period of time, their use has been overlooked in the treatment of chronic diseases and disorders. Indeed, there’s been poor coordination between the specialists and the generalists who want to establish pain management as a specialism in its own right. Those who have built their empires on the back of particular injuries or diseases, are reluctant to give up control of patients to a new department that might challenge their authority. The result is long waiting times for people with chronic pain to get effective treatment for the pain.

Speaking at a recent European conference, Professor Varrassi reported the results of a long-running study. About 25% of adults in Europe are affected by some degree of chronic pain. Lower back pain is actually the second most common reason for people to visit their doctor in search of treatment. Yet the average delay between the first consultation and a reference to a specialist pain center is about twelve years. The main reason for this long period is that doctors prefer to continue dealing with their patients even though this may mean nothing more than increasing the potency of the painkillers used. This leads to a constant battle to balance the reality of the pain against the side effects of the opiate drugs most often used. Professor Varrassi strongly argues for a complete reeducation of doctors. The evidence clearly shows there is a strong neuropathic element to chronic pain, and continuing treatment for a physical condition is not going to work. Read the rest of this entry »