You know you are in MBBS when....
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You know you are in MBBS when....

  • When drinking, you and your friends think that the increase in your AST/ALT tomorrow is going to be hilarious!
  • You still do drugs, but at least you know what they do to you. And never fail to inform those you're doing them with.
  • You blame neurotransmitters for anything going wrong in your life.
  • You can have a conversation about the abscess you drained today while eating cream of broccoli soup without any problem at all. Or for that matter, over any kind of meal.
  • You amuse yourself by hiding anatomy and trauma pictures about the apartment for your non-medical roommate to find at awkward moments.
  • You chuckle whenever you see "fork" or "penis" labeled in a Netter's diagram.
  • You still attempt to explain to your family what's going on in med school.
  • You have named a dead person ... and talked to them about your stresses while finding their lumbar plexus.
  • When you go out with non-medical students, you're abnormally quiet, because you don't know what to talk about besides med school.
  • You know that specialties are pre-defined by personality type.
  • The drama in your life now is worse than it ever was in high school.
  • You refer to the semesters you took organic chemistry as "The Good Old Days."
  • You've ever heard the phrase "You must be smart, you're in med school!" and wanted to vehemently disagree.
  • You can't remember the last time you did anything spontaneous.
  • You consistently tell people that they just don't understand how bad it really is. (Yes, yes, and yes.)
  • You know that, in theory, you have a family and friends, but you can't place the last time you saw them.
  • You don't bother dating because the divorce rate is 70% for physicians.
  • You constantly find yourself saying things like "I just have to get to spring break" or "I just have to get through Step 1."
  • You question every day if you should drop out and open a coffee shop (for me, it's a photography studio) then realize that as soon as you were two semesters into med school, you were too far in debt to be anything but a doctor.
  • You can name the four people in your class who are the question-asker, the arguer, the bigshot doctor's son/daughter and the stoner/alkie/druggie who's never IN class. (Haaa. Yes.)
  • You know countless dirty mnemonics for parts of the body, but couldn't tell anyone what the front-page headline today is.
  • Your life consists of three parts: studying, drinking, and sleeping. (For me, replace "drinking" with "procrastinating", "crying", or "doing the running man in socks on my wood floor out of sheer delirium".)
  • You're not really sure which professional organizations you're actually a member of, but you never joined the AMA.
  • You've compared your friends to various immune system components, or some other enzyme. (Someone else does this???)
  • You notice your friends ask you how schools going, then realize they immediately regret it when you actually answer.
  • People assume you know something when you tell them you're in med school, but you know that you haven't learned anything.
  • You've dissected a penis and can explain the way viagra cialis online pharmacy pharmacy works.
  • There are still drugs, body parts, slides, cell types, or diseases you don't know the morning of your exam.
  • You know that there is such a thing as studying too much and that after a certain peak, your grade starts going down with increased studying.
  • You know that even with residency hour restrictions, you're still making less than the secretary.
  • People constantly ask what med school is like, and all you can think of to say is "It really sucks." (Really, REALLY sucks.)
  • You've never had problems before, but 6 months into med school you're on birth control, an anti-depressant, an anti-anxiolytic and sleep medication. (I'm afraid my dad just had a heart attack here. Don't worry, Dad - for me, one should replace "birth control" with "pain meds for my eeeeevil pancreatitis which is aggravated by stress".)
  • You can name 3 specialties you're interested in, then immediately rule two of them out because they don't pay well enough to pay off your debt.
  • Half your class is Asian of some sort. The other half is Jewish. All of you are completely nuts.
  • A "study group" is you, your syllabus, and your Red Bull. (And Christy.)
  • You assess beverages for amount of caffeine before buying only those with more caffeine than coffee. Then you explain to the cashier how caffeine works for you.
  • You've done physical exams on your roommate, boyfriend, girlfriend, and any close friends.
  • You think "AWESOME!" if someone keels over in front of you.
  • You're pretty sure you used to be a normal social person, but now you can completely stop conversations by talking about the time that guy peed and bled all over you during a code.
  • You meet someone and have to put off a date for months because you're crazy busy.
  • Advisors tell you that you have to balance your life with med school, and then are baffled when you ask them how to do it.
  • You've thought something like "what's another $10,000 in loans?"
  • You're really frightened by the thought of some of your classmates becoming doctors. (I'm afraid my classmates think this about ME!)
  • You go a week without sleeping with no problem at all. (I still haven't figured out how to do this.)
  • Grey's Anatomy, House, Scrubs, Dr. 90210, Nip/Tuck and ER are your favorite shows, but you point out all the wrong things in them all the time.
  • You have diagnosed yourself or others with at least 5 rare diseases (PML, Kaposi's sarcoma, Measles, Rheumatic Heart Disease, etc.) (No, one eeeeevil rare disease that I actually have is enough.)
  • People talking to you for longer than 10 minutes start to get a glazed-over look while you wax poetic about kidney function. And you don't even notice.
  • You keep trying to "catch" the kidney, because Bates says you can. Nevermind that every doctor you know says you can't.
  • You create Facebook groups instead of studying for exams.
  • The word "holiday" indicates the weekend after exams to you.
  • You have a non-medical student in your life who either elbows you when you say inappropriate things or says "forgive him/her, s/he's a med student."
  • You have mastered the art of only remembering things for a few hours (specifically, the 12 hours up to and including the exam.)
  • You remember mnemonics from anatomy, but don't actually remember what they stand for.
  • You have at some point had a yelling, screaming, throwing things, breaking down and crying incident in the last month. (How about in the past week? Day? Hour?)
  • Your parents ask what you want for Christmas and you say "to be done with this semester."
  • Your sibling calls you crying or upset, but in the middle of their hysterics, asks you if you're studying or if you can take time to talk, concerned that they're bothering you.
  • You've thought something along the lines of "Couldn't my cousin/grandfather/brother have waited to get married/die/come visit until exams were over?"
  • You've read, heard, or wrote a poem, performed or choreographed a dance, or drawn pictures of anatomy, anatomy lab or med school in general.
  • You lose something like your license or cell phone a week before exams and don't even realize it's gone til afterwards.
  • You have heard classmates say "I'm going to fail" before the exam, many who then told you they got over a 90% on the exam ... and many who really did fail and got a 9%.
  • You see or hear about some disease or medically-related thing and instantly think "am I supposed to know that?"
  • You still think that patients actually will fit right into symptom parameters set by textbooks.
  • You've read House of God, don't totally get it, but know that you will when you're an intern.
  • You're anti-war, nonconformist, and dislike structure - yet still considered doing the Army/Navy/Air Force Health Programs in order to have them pay off your debt. (I'm totally NOT anti-war and nonconformist. But y'all already knew that.)
  • You find yourself becoming more like House and Dr. Cox as time goes on.
  • You watch medicine on TV shows and think "HA! As IF!"
  • When you talk about school to friends and family and every sentence is followed by "...is that good?"
  • You celebrate a 70 on a test. (Yes. With balloons and confetti, even.)
  • You've purposely sacrificed two tests in order to get an 80 on the third ... because there's absolutely no way to ace 8 subjects at the same time.
  • You see neurons in soap suds in your shower.

Supplement Summary and Comparison
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I compiled a comparison summary list of supplements and vitamins for AS women based on the Asherman’s Online Group members' emails and database vs. the recommendations I got at The Fertile Soul retreat. They are actually really similar. I also emailed Kathryn Simmons-Flynn, the nutritionist for The Fertile Soul and Fertile Foods to clarify which ones to stop at ovulation/pregnancy. She said I could do all of them the entire month but to stop only if I found out I was pregnant. You should ask your doctor which supplements to stop one to four weeks prior to surgery, as several supplements have blood thinning properties. I stopped taking the Chinese Herbs, baby aspirin, Vitalzym SEB, fish oil, OPC, CoQuinone 30 and Proflavanol 90 for two weeks prior to my scheduled surgery.

I hope some other women can also make use of this information by doing their own research, asking their own support network of practitioners and deciding what’s best for each unique body and situation. For a complete overview of dietary, exercise, massage, acupuncture and herb recommendations, see my earlier post.

Supplement Recommendations Summary and Comparison

Key:

Blue=Fertile Soul Recommendation

Green= AS group Recommendation

A. Core Group of Supplements Recommended by both AS Group (for Asherman’s) and The Fertile Soul (for lining and implantation issues) AS recommends the type, while the Fertile Soul recommends the specific brand in blue and parentheses.

1. Pre Natal Vitamin (USANA Chelated Minerals + Mega Anti-Oxidants= multi-vitamin) General Health and antioxidants

2. Folic Acid (USANA Mega Anti-Oxidants contains 1000 mcg folic acid) Heart health, healthy pregnancy and fetal development

3. Vitamin E (USANA Mega Anti-Oxidant contains 400 IU Vitamin E) Antioxidant, heals tissue, heart health

4. CoQ 10 (USANA CoQuinone 30 (2 online pharmacy viagra contain 60mg CoEnzyme Q-10) Heart health, boost immune system

5. Raspberry Leaf Tea (Raspberry Leaf Tea) Tones the uterine lining, regulates menstruation

6. Baby Aspirin (Baby Aspirin) Blood thinning properties, circulation

B. Additional Supplements Recommended by several AS group members (for Asherman’s) and The Fertile Soul (for implantation and lining issues). AS group members recommend the type, while the Fertile Soul recommends the specific brand in blue and parentheses.

1. Fish Oil (USANA Bio-Omega Fish Oil is best, but Nordic Naturals Fish Oil is good) Reduce inflammation/cholesterol, circulation,

2. OPC (Saratoga Supplements or AlwaysBuying.com are best) Boosts immune system, circulation

3. Chinese hebs (individual prescription) (Chinese herbs --individual prescription)

C. Recommended only by The Fertile Soul (for implantation and lining issues):

1. Vitalzym SEB (with Nattokinase) or Vitalzym Heals scar tissue, dissolves fibroids, boosts immune system, circulation

D. Recommended only by the Fertile Soul (for all women TTC):

1. USANA Proflavonol 90 (similar to OPC) Boosts immune system

2. USANA Active Calcium Healthy bones

E. Other General Supplements I’m taking

1. Evening Primrose Oil (Whole Foods, Bluebonnet) Reduce inflammation, improves cervical mucus, helps dry skin

2. Iron (Floradix Floravital Iron and Herbs) Helps the blood absorb and transport oxygen, builds the blood

3. USANA Visionex Promotes Healthy Vision

4. Probiotic (Ultimate Flora Critical Care) Promotes digestion, prevents yeast infection, offsets antibiotics with microflora

5. Goji Berry Tea (brewed from organic dried Goji Berries)

F. AS Group members recommend to stop at ovulation and pregnancy:

1. CoQ 10

2. OPC

3. Evening Primrose Oil (Whole Foods, Bluebonnet)

G. The Fertile Soul recommends stop during pregnancy only:

1. USANA CoQuinone 30

2. Vitalzym SEB or Vitalzym

3. USANA Proflavanol 90

4. Chinese herbs (at discretion of your acupuncturist)

5. Evening Primrose Oil (Whole Foods, Bluebonnet)

6. USANA Visionex


Cialis
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See also: cialis | 



Since the hot topic this week in class discussion was about drug ads, I figured I'd bring in the male enhancement portion of them. I think it is crazy that pharmeceutical companies can even advertise on TV, but it is very strange that we allow male enhancement ads. These ads are especially frequent on sports channels, during football and later at night. I personally do not like these ads with all of the male and female fondling, and the awkward fake intimacy of the actors. I don't necessarily like these ads at all, nor do I really care to watch them.

Cialis is a brand that has advertisements all over the television. Men with erectile dysfunction are supposed to take the 36 hour pill. Of course the ad also says talk to your doctor to see if viagra is right for you. I agree that it is very strange that people are being asked to ask their doctors to take a pill. The doctor is no longer suggesting a pill, but the patient is. It is a complete reversal of roles. But these commercials are trying to promote the product and get men to believe they have erectile dysfunction or that they need this miracle drug to help their sex lives. The commercial only quickly discusses (in the very fast talking, while people are floating around being super happy) the possible symptoms such as back pain, indigestion, headache, muscle aches and more serious things like decrease or loss of vision and hearing. I think that that is kind of a big deal, although I'm glad that the side effects do not say that death or heart attack is possible. It also says that if your erection last longer then 4 hours, you should call your doctor. I can't imagine that that would be a nice experience for anyone. I am glad that these companies are supposed to tell the side effects though because they are very important for the consumer. Overall, I think that it is ridiculous that the US still allows these ads on TV. People should tell their doctors what their problems are and then the doctor should suggest products, not the other way around.

The Benefits of Keeping the Penis Intact
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By Travis Wisdom



Introduction

There is an increasing number of American parents who are saying no to non-therapeutic routine circumcision. This crucial choice will allow their boys increased health benefits in addition to enjoying the unequivocal pleasures of their foreskins later throughout life. While the circumcision rates continue to slowly decline in the United States, those who choose foreskin-friendly parenting find themselves in direct contrast of the greater circumcising culture. This consequently causes increased uncertainty about the decision that they elected as well as perplexities on behalf of the physicians who often provide inaccurate and misleading, if not completely fraudulent, information on the importance of the prepuce, its benefits and vital roles to optimum sexual function and health, and proper hygiene and care for intact boys and men.



This essay surveys various protective, mechanical, sensory, and sexual benefits and functions of the foreskin that would otherwise be lost to its surgical amputation. I discuss genital hygiene and care for the intact cialis with hopes to help alleviate confusion and ignorance surrounding cleanliness. In anticipation, having an understanding of the benefits and functions of the human foreskin is useful for both the parents and the physicians in order to gain an appreciation and respect for intact genitalia.



Benefits of the Prepuce

George Hill defines the human prepuce, or foreskin, as a specialized organ that offers protective, mechanical, sensory, and sexual functions, all of which are necessary for operative sexual health [1]. All healthy functional males are born with the following preputial capabilities and should enjoy their benefits and functions throughout adulthood.



Protective

The article, Foreskin Sexual Function/Circumcision Sexual Dysfunction released by the Circumcision Information Resources Pages (CIRP) collaborates various scientific sources to examine the role of the foreskin in human sexuality in addition to studying the dysfunction that is cased by surgical amputation.



The foreskin either partially or completely covers the glans penis in the adult male protecting it from dryness and abrasion [2]. Remaining protected from foreign stimuli, the foreskin maintains the subpreputial area wet and moist with prostatic, vesicular, and urethral secretions [2]. The subpreputial moisture contains lysozyme, which destroys pathogens [1]. It is important that the glans remain in this state of moisture and wetness because it is covered with mucosa, not skin. In addition, the prepuce guards from the process of keritinization. This otherwise would cause the glans to thicken as skin cells begin to layer, which deadens sensation [2].



In infant boys, the prepuce protects the meatus from ammoniacal diapers and prevents meatitis, meatal ulceration, and meatal stenosis. E. coli that is found in feces is the most important pathogen in urinary tract infection. The muscle fibers in the foreskin act as a preputial sphincter, helping to prevent UTI in infants as it forbids contact between the meatus and feces. Additionally, the foreskin also helps to reduce incidence of non-specific urethritis and presence of Staphylococcus aureus in the urethra [1].



Mechanical

An important mechanical function of the foreskin is its ability to facilitate intromission and penetration [2]. As the foreskin unfolds, the penis enters his partner reducing friction, dryness, and abrasion allowing intercourse to be more comfortable [1].



Also, the presence of the foreskin allows for less forceful penetration. After penetration, the foreskin provides a unique gliding action that substantially reduces friction and vaginal dryness [1].



Sensory and Sexual

The foreskin is a specific erogenous zone that is the most heavily innervated part of the penis with nerve endings near the surface of the ridged band. This band originates from the frenulum and encircles the opening of the foreskin [2]. The tissue whose nerve endings most sensitive to fine touch and temperature is located in the foreskin [1].



The foreskin has a layer of a smooth muscle tissue, the peripenic muscle, which comprises a portion of the dartos muscle [2]. The nerve-endings that are present in the foreskin become stimulated through motion and stretching [1]. Through the contractions of the unique muscle fibers in this tissue, the foreskin obtains strong elasticity, which is crucial to erogenous sensation. The muscle tissue must stretch to glide over the glans upon erection, later to return to its normal flaccid coverage. The stretching movement produces great sensation and pleasure. The nerve endings produce pleasurable erotic sensations, which travel to the central nervous system, inputting to the autonomic nervous system. This process plays a vital role in controlling erection and ejaculation [2].



Nerve endings of the glans are concentrated in the corona. Likewise, they intrude against the corona during intercourse [2]. The foreskin protects the corona from direct stimulation, and because it is the most highly innervated part of the glans penis, this helps to prevent premature ejaculation [1].



Genital Hygiene

The foreskin is one of the most easiest cared for parts of the human anatomy, and the most important rule to remember is: only clean what is seen [3]. Proper infant hygiene, for both boys and girls, is just that straightforward. In fact, Marilyn Milos, RN describes the cleaning of the intact penis as very similar to cleaning one’s finger [4]. Only clean the external genitalia, what is exposed, using warm water. Soap is not needed. Intrusive or interior cleaning is absolutely never needed. The boy’s foreskin will naturally retract at a point in his maturation that is unique to him, usually around puberty. It is utterly imperative to note that forcible retraction should always be avoided, as it causes trauma, pain, and destruction of the developing tissue and natural flora [4]. Of course the penis is immature at birth, and the foreskin is connected to the glans via a special membrane that ensures cleanliness and protection of the underlining penile structures [3]. In addition, this membrane also protects the high nerve supplied and erogenous foreskin of the developing penis from foreign stimuli, such as those found in feces, the ammonia in urine, and invading pathogens [3].



Both John V. Geisheker and John W. Travis in the article, “Only Clean What Is Seen: Reversing the Epidemic of Forcible Foreskin Retractions,” agree that while the foreskin is different in structure, it is appropriate to conceptualize it as the male’s hymen, protecting the internal sexual organ during the years when they are not needed for sexual purposes. In time, the membrane within will disappear as the child matures [3].



Once the boy has discovered that his foreskin is (naturally) retractable, he can easily care for his body through three easy steps: retract, rinse, and replace [4]. First, he can retract his foreskin. Using only warm water, he should not apply soap or any other substances on the mucosa membrane of the glans or the inner lining structure of the foreskin. Then, release the foreskin and allow it to naturally glide to its position [4].



Conclusion

Having an accurate understanding and appreciation of the advantages of the male prepuce will begin to offer women the opportunity to empower their lives and child birthing experiences. It is important that physicians be given legitimate resources on just how vital the foreskin is to protecting against disease and invading pathogens [1]; in addition to offering functional sexual organs with necessary skin mobility for intercourse as well as the opportunity to enjoy the full potential of the pleasures of sexual intimacy [1]. Also, the care for such a uniquely viable organ is extraordinarily simple. The prepuce can be cleaned and cared for with warm water, without the use of any artificial substances like soap, or invasive internal cleaning [3]. The first person to retract a boy’s foreskin should be the boy himself. Everyone else should leave it alone and let nature function in its own right. The membrane embedded under the foreskin is the male’s first line of defense against infection, and the foreskin’s forcible retraction disrupts this protective order, causing necessary and avoidable trauma and pain [4].



The advocacy for better knowledge of the male sexual organs helps to dispel myths about the human body and male sexuality as well as taboos surrounding childbirth. These available resources allow for an informed decision on foreskin-friendly parenting based on awareness and education as opposed to common inaccurate and misleading beliefs that can otherwise promote damage to the male body or cause unreasonable guilt for protecting boys from the damages of non-therapeutic circumcision.





References:

[1] Hill, G. (2007). The Case against circumcision. Journal of Men's Health and Gender, 4(3), 318-323



[2] Foreskin Sexual Function/Circumcision Sexual Dysfunction. Circumcision information resource pages. Retrieved (2009, September 07) from http://www.cirp.org/library/sex_function/



[3] Geisheker, JV, & Travis, JW. (2008, May 30). Only Clean what is seen - reversing the epidemic of forcible foreskin retractions. Kindred Community, 28-33.



[4] Milos, MF. (2010). Letters to the Editor: Re: Provencio-Vasquez, E. & Rodriguez, A. (2009). Collaborative practice: Circumcision revisited. Journal for Specialists in Pediatric Nursing, 14(4), 295-297. . (2010). Wiley periodicals, Inc.



About the author
Travis is pursuing Bachelor’s degrees in Philosophy and Women’s Studies, with a minor in Sociology. He is an intern for Doctors Opposing Circumcision and an affiliated member of Intact America, Feminist Majority Foundation, and the National Organization for Women. Travis has participated in various feminist conferences throughout the United States and is an active intactivist. He strives for better knowledge and awareness of genital tissue, its diverse functions and roles, in order to promote integrity and protection from invasive and damaging non-therapeutic and religious circumcisions on children. Most recently, he founded the Las Vegas, Nevada chapter of the National Organization of Circumcision Information Resource Centers.  

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