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Low T, or Low Testosterone, can Affect a Man in Many Ways, Says Paul Perito MD

February 20, 2012 By 10 Comments
Paul Perito MD

Paul Perito MD

Florida-based urologist Paul Perito MD says there are two predominant forms of testosterone replacement. He recently sat down with Interviewing Experts for a quick conversation about this common condition.

Interviewing Experts: We appreciate your time today, doctor. What is testosterone?

Paul Perito MD: Testosterone is the male hormone that is responsible for muscle mass, facial hair, and bone density.

Interviewing Experts: Is testosterone stable throughout a man’s lifetime?

Paul Perito MD: After the age of 40, some men will begin to experience diminished testosterone levels.

Interviewing Experts: What are the side effects of low testosterone?

Paul Perito MD: It can result in other medical conditions such as high cholesterol, poor cardiac health, and a lack of vitality.

Interviewing Experts: What symptoms do men experience as a result of low testosterone?

Paul Perito MD: Patients will describe not remembering things, they will describe having decreased libido and not wanting to engage in sexual activity with their partners.

Interviewing Experts: That has to really affect a man emotionally.

Paul Perito MD: One study indicates an increased risk of depression in men with low testosterone levels.

Interviewing Experts: Testosterone can be replaced, correct?

Paul Perito MD: Yes it can.

Interviewing Experts: Can you tell us how?

Paul Perito MD: Most of the testosterone replacements that you’ll see right now are either injectables, creams or long acting pellets.

Interviewing Experts: What are the benefits of testosterone therapy?

Paul Perito MD: Studies suggest that testosterone can improve cardiac health and reduce the threat of diabetes.

Interviewing Experts: Those are physical side effects; are there any neurological side effects?

Paul Perito MD: They’ve shown the man’s ability to think is improved dramatically once they restore their natural testosterone levels.

Interviewing Experts: When should a patient speak with their doctor?

Paul Perito MD: When it becomes a problem in their life or relationship.

Interviewing Experts: Is testosterone replacement right for everyone?

Paul Perito MD: Not necessarily, patients should speak with their doctor to find out if testosterone replacement is right for them.

Interviewing Experts: Very interesting, we hope that all of our readers will take this into consideration if they suspect they have low testosterone levels.

Urological surgeon Paul Perito MD has devoted his entire professional career to treating men suffering from Erectile Dysfunction. He is the founder and namesake of Miami’s Perito Urology, where he conceived and initiated the world’s first minimally invasive approach to penile implantation. Paul Perito MD has performed over 3000 of these procedures on men across the globe, and his patients enjoy a shorter recovery time and less scarring than traditional implantation methods. Since 1995, Paul Perito MD and Perito Urology have become synonymous with effective erectile dysfunction treatment and world-class service unparalleled anywhere in the nation. He is a graduate of the University of Maryland Medical School as well as a frequent contributor to text published by medical journals nationwide.

The information contained in this article is provided by Paul Perito MD for educational purposes only. It is not intended to treat or diagnose any condition.

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Dr. Paul Edward Perito MD: What to Know Before You Start a Urology Residency

February 9, 2012 By 10 Comments
Dr. Paul Edward Perito MD

Dr. Paul Edward Perito MD

Before creating his revolutionary penile implant procedure, Dr. Paul Edward Perito MD served residencies in Australia and Florida. During college, Dr. Paul Edward Perito MD also participated in an exchange program that allowed him to work in Africa for a time. Currently, Dr. Perito trains 2 to 8 urologists a month in the Minimally Invasive Penile Implant, an implant procedure he patented over 6 years ago.  Today, Dr. Paul Edward Perito MD explains the various choices for young students interested in pursuing a career in urology.

Q: Dr. Paul Edward Perito MD, as founder of Perito Urology, what advice do you have for students struggling to decide which residency program to choose?

Dr. Paul Edward Perito MD: Today’s students are lucky in that they can do online research on various residency programs before making a choice. The first thing a student should do is evaluate the curriculum of the residency program he or she is considering. Will you get the training you’ll need to continue into a career in urology? The more variety, the better. You’ll need to be exposed to several fields of urology to be able to diagnose and treat a wide variety of conditions over the course of your career.

Q: How many different fields of urology are there, Dr. Paul Edward Perito MD?

Dr. Paul Edward Perito MD: That’s a good question. There are urologists who specialize in pediatrics, oncology (cancer), renal transplants, and infertility in male patients, urinary tract stones, female urological conditions, urinary incontinence and impotence.

Q: Aside from the clinical materials, Dr. Paul Edward Perito MD, what else should students consider when interviewing for a residency?

Dr. Paul Edward Perito MD: The nature of the residency is important, of course. Will the residents be able to attend conferences and workshops to further their knowledge? Will the residents be active in publishing?

Q: Exposure to different subspecialties is important in a residency…

Dr. Paul Edward Perito MD: Absolutely. In fact, students considering a residency should research the background of the involved faculty. Are these experienced professionals in various areas of urology? And will the faculty be large enough in number to be able to give each student the case-load and case variation necessary to be considered properly trained?  Very few programs in the United States lack in this area.

Q: Dr. Paul Edward Perito MD, what should a student look for in the hospital or learning institution where he or she decides to complete a residency?

Dr. Paul Edward Perito MD: Research is important. Is the facility attempting to find new ways to implement old methodologies? A faculty that is always eager to learn and push the boundaries provides a great example for students. Does the facility have updated equipment? A student will need to make sure he or she is getting experience that will translate to today’s world of medicine.

Q: How many interviews should a student attempt before settling on a choice for a residency?

Dr. Paul Edward Perito MD: That’s an individual choice, but it’s important that each student find a facility that shares his or her goals and temperament. That right fit can be hard to find, but it’s well worth going on as many interviews as possible to find that perfect fit.

 

Dr. Paul Edward Perito MD is the founder of Perito Urology and the Chairman of Urology at Coral Gables Hospital in Florida. To contact Dr. Paul Edward Perito MD, go online to www.peritourology.com

The information contained in this article is provided by Dr. Paul Edward Perito MD for educational purposes only. It is not intended to treat or diagnose any condition.

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Erectile Dysfunction Expert Dr. Paul E. Perito Says That Erectile Dysfunction Treatments Are Discrete and Customizable to the Patient

January 30, 2012 By 10 Comments
Dr. Paul E. Perito

Dr. Paul E. Perito

In a recent interview with Interviewing Experts Blog, Dr. Paul E. Perito spoke candidly about the embarrassing side effects of erectile dysfunction and how penile implants can help.

Interviewing Experts: What type of procedure do you use when you perform a penile implant?

Dr. Paul E. Perito: The implant procedure that I have created is slightly different from ones done in the past. It’s an approach through the area just above the penis called the infrapubic area. And we call it the minimally invasive penile prosthesis, because in 10 min. the entire device can be put inside the body.

Interviewing Experts: So you can’t see anything?

Dr. Paul E. Perito: The entire implant is hidden inside the penis and scrotum. There are the cylinders that fill with saline. The pump goes inside of the scrotum. There’s a third part that I never describe because it’s inconsequential to patient, but that’s the reservoir that allows fluid to go out to the cylinders.

Interviewing Experts: So what does the implant do?

Dr. Paul E. Perito: It re-creates exactly what the patient used to have. Before, when he wanted to have sex, blood would fill the cylinders of the penis, called the corpora cavernosa. In this case saline fills the cylinders. When you want to have sex you pump the pump that is in the scrotum and it fills the cylinders.

Interviewing Experts: So it looks like a natural erection?

Dr. Paul E. Perito: These implants are the most physiologic replication of an erection. When you are done, there is a deflate mechanism and you squeeze and it allows all the fluid to go back into the reservoir.

Interviewing Experts: What does impotence do to the body; specifically to the penis?

Dr. Paul E. Perito: The one thing that you need to know is that the longer you remain impotent without treating yourself, the shorter the penis becomes. And there’s been excellent papers written where we render a guy impotent in a single day with a radical prostatectomy. You take his prostate out and he is rendered impotent in one day and then we follow his penis length in a process called the penile stretch test. A patient can lose anywhere from .5 to 5 cm every 14 months, that is one of the most reliable papers that I’ve seen.

Interviewing Experts: That is a significant loss in length.

Dr. Paul E. Perito: Yes it is. When I take patient measurements at the initial penile stretch test and I will tell them, “this is what you’ve got.”  Then I’ll push their penis up against the pubic bone and I will tell them, “If you wait another year, this is where you will be.”

Interviewing Experts: Is there way to stop the diminishing effects of erectile dysfunction?

Dr. Paul E. Perito: Truly you need to initiate some form of therapy if you are concerned about penile length as soon as erectile dysfunction occurs.

Interviewing Experts: Now are the implants one-size-fits-all?

Dr. Paul E. Perito: No they are not. They can vary considerably in size.

Interviewing Experts: So once you measure the length that is how you decide what size of implant to use?

Dr. Paul E. Perito: Intra-operatively, we measure the length with a device called a Furlow. And with every guy you give them back exactly what they have at that moment.

Interviewing Experts: Will all men retain the same length?

Dr. Paul E. Perito: I just wrote a paper that showed that 75% of men will have the same length postoperatively as they did prior to the procedure. So there is a predictive index that we can utilize.

Interviewing Experts: And this is sometimes covered by insurance?

Dr. Paul E. Perito: Medicare pays for penile implant because the penis is a functioning organ. Studies have shown that ongoing intimacy does indeed lead to a longer, healthier life.  Medicare pays for it, private insurance pays for it, and some HMOs pay for it. Often times it depends upon the cause of the impotence.

Interviewing Experts: Very informative, thank you very much.

Dr. Paul E. Perito: You are welcome.

***

Dr. Paul E. Perito graduated the University Of Maryland School Of Medicine in 1988. His Coral Gables, Florida, urology center, Perito Urology, draws patients from around the globe for its innovative and updated Erectile Dysfunction treatments. Having successfully performed over 3,000 penile implants since 2005, Dr. Paul E. Perito is considered a leader in the field. His signature minimally invasive technique, The Perito Approach, has been taught to surgeons worldwide through travel and at Coral Gables Hospital, where he is Director of Urology. Dr. Paul E Perito is has participated in countless medical studies in his quest to simplify the penile implant process and make the procedure safer for his patients.

The information contained in this article is provided by Dr. Paul E. Perito for educational purposes only. It is not intended to treat or diagnose any condition.

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Interview with Dr. Paul Perito: The Efficacy of Minimally Invasive Penile Implantation

January 12, 2012 By 10 Comments
Dr. Paul Perito

Dr. Paul Perito

Interviewing-Experts Blog recently had the opportunity to speak with renowned Erectile Dysfunction expert, Dr. Paul Perito, about the importance of utilizing a minimally invasive technique when performing a penile implant.

Interviewing-Experts: Good morning, Dr. Paul Perito. Thank you for speaking with us today about such an important topic.

Dr. Paul Perito: Certainly. Men’s health is a subject often ignored. I appreciate the opportunity.

Interviewing-Experts: So, please tell us a little about what makes your technique different from previous procedures.

Dr. Paul Perito: There are several key differences. I do not use a Foley catheter since I do not drain the bladder. I limit my dilatation, ensure that the reservoir is behind the transversalis fascia, use an artificial erection at the beginning of the procedure, and finally, there’s the use of a drain. My approach is infra-pubic, and as minimally invasive as possible. I think there are nuances that make it better than prior procedure techniques.

Interviewing-Experts: What kind of results have you seen from these differences?

Dr. Paul Perito: Our results have been good. Our infection rate was only .91% in the last 1,000 procedures.

Interviewing-Experts: That sounds very promising.

Dr. Paul Perito: Aside from that, there were only 2 distal urethra injuries, which were repaired primarily at the time of the procedure and two scrotal hematomas that were evacuated.

Interviewing-Experts: What do you consider the greatest measure of success for this procedure?

Dr. Paul Perito: How quickly my patients have gotten back to normal sexual function.

Interviewing-Experts: That’s certainly important.

Dr. Paul Perito: Yes, it is. 82% of patients were back to normal function within four weeks; the rest by six weeks.

Interviewing-Experts: Very interesting.

Dr. Paul Perito: These results tell me that the procedure is efficacious, expedient and safe.

Interviewing-Experts: How do you know what size to make the penis with the implant? Is there a way to gauge a patient’s natural penis size?

Dr. Paul Perito: Yes, there is. First, it’s important to know that when you render a man impotent, say with a radical prostatectomy, over the course of the next 14 months he’ll lose anywhere from .5 to 5 cm in length.  I use a penile stretch test to educate patients on what they can realistically expect postoperatively.

Interviewing-Experts: How did you conclude that the stretch test was the best predictive index for length?

Dr. Paul Perito: What I did was took 53 patients and measured their artificial erections, their penile stretch test and finally what they had at the end of the procedure. And, not surprisingly to me, the best predictive Index was the penile stretch test. So now when a patient comes into office and they want a penile implant, I’ll do the penile stretch test and tell them that 72% of the time, this is what they are going to have postoperatively, and if they don’t like that, they should probably not get a penile implant.

Interviewing-Experts: Sound advice, indeed.

Dr. Paul Perito: Additionally, since my procedure does not use a Scott retractor, the cost is reduced. My penile pack costs $72 to the hospital, and these days cutting cost is essential.

Interviewing-Experts: Absolutely. Well, Dr. Perito, we look forward to hearing more about this procedure in the future, and again thank you for taking the time out of your surgery and training schedule to speak with us today.

Dr. Paul Perito: You’re welcome.

 

***

Dr. Paul Perito is a 1988 graduate of the University Of Maryland School Of Medicine. His practice, Perito Urology, is considered one of the foremost Erectile Dysfunction treatments centers in the world. Since 2005, Dr. Paul Perito has successfully performed more than 3,000 penile implants, establishing him as a leader in the field. He has streamlined the procedure, making it not only more efficient, but safer, by the development and actualization of a minimally invasive approach. Aside from contributing extensively to medical publication libraries, Dr. Paul Perito heads the training center at Perito Urology where his technique is taught to an audience of surgeons from across the globe.

The information contained in this article is provided by Dr. Paul Perito for educational purposes only. It is not intended to treat or diagnose any condition.

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Personal Case Prompts Pharmacist to Start Madison Pharmacy Associates

January 2, 2012 By 8 Comments
Madison Pharmacy Associates

Madison Pharmacy Associates

While working at a local Madison pharmacy in the late 70s, Marla Ahlgrimm and one of her pharmacist colleagues identified a syndrome of symptoms that affected several of their female patients severely.  These symptoms occurred regularly, every month from day 14 or ovulation, to  day 28 or the onset of menstruation. At the time, there was no known cause or treatment options  to successfully manage these symptoms. Although Ahlgrimm would eventually identify the symptoms as premenstrual syndrome (PMS), it would still be years before the term “PMS” became widely used in the United States. In the meantime, Marla Ahlgrimm co-founded Madison Pharmacy Associates in 1982, a Madison, Wisconsin based practice where they counseled women on health issues and dispensed customized, natural hormone prescriptions for women.

Madison Pharmacy Associates was the first pharmacy in America to identify and develop treatment options for premenstrual syndrome in the U.S., which is estimated to affect more than 40% of all women between the ages of 14 and 50. With over 150 symptoms reported, PMS includes irritability, anxiety, crying for no reason, cravings for sweets, fluid retention, headaches, depression, and fatigue. Using natural progesterone therapy, Madison Pharmacy Associates was able to help many patients and their doctors manage symptoms without the use of tranquilizers or antidepressants. Progesterone is the most commonly prescribed medication for PMS, according to Madison Pharmacy Associates’ Ahlgrimm. Madison Pharmacy Associates dispensed progesterone in capsule, tablet, suppository, and transdermal cream dosages, individually compounded for each patient.

In addition to customized hormone therapy, the expert staff at Madison Pharmacy Associates counseled patients on self care options including diet, exercise changes and the use of specific nutritional supplements that can make a difference in managing PMS. “65% of patients were able to manage severe symptoms with self care alone, without the need for prescription therapy” Madison Pharmacy Associates co-founder Marla Ahlgrimm says.

Madison Pharmacy Associates provided prescriptions to PMS sufferers throughout the country. Madison Pharmacy Associates offered toll-free 800 lines to field women’s health questions and help them find knowledgeable doctors to work with.

Madison Pharmacy Associates also provided PMS  information and education to any women who called. “It created anonymity, which helps when you’re talking about the menstrual cycle or personal symptoms,” Madison Pharmacy Associates’ Ahlgrimm says.

Madison Pharmacy Associates grew from its original 700-square-foot pharmacy to 17,000 over 30 years but the mission of its co-founder to always put patients first remained the same. Over the years, Madison Pharmacy Associates has helped more than 300,000 women with symptoms related to premenstrual syndrome, perimenopause, and menopause.

The information in this article has been previously published and is provided as a reference resource by Marla Ahlgrimm, R.Ph. The businesses referenced above were sold in 2011. Marla Ahlgrimm is also the co-founder and President of Cyclin Pharmaceuticals, Inc. The company sells proprietary products for the women’s health market as well as ProCycle PMS and ProCycle Gold products. For more information, go online to www.cyclinpharma.com

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Pharmacist Marla Ahlgrimm Answers Your Questions

January 2, 2012 By 8 Comments
Marla Ahlgrimm

Marla Ahlgrimm

A pioneer in the field of hormone therapy (HT), Marla Ahlgrimm has helped more than 300,000 women manage their symptoms of premenstrual syndrome (PMS), perimenopause, and menopause. Marla Ahlgrimm, founder and CEO of Women’s Health America, receives many questions from women and will answer several of the most common ones.

Q: What is a natural or bioidentical hormone?

Marla Ahlgrimm: When choosing between hormonal medications, a woman and her doctor must select between hormones that are natural or bioidentical and those that are synthetic. A natural or bioidentical hormone is identical – has the same chemical structure – to those hormones naturally produced by a woman. These may include estradiol, estrone, estriol, progesterone, and testosterone. In contrast, synthetic hormones are similar to, but not identical chemically to those produced naturally by a woman. These include oral contraceptives, Provera, Premarin, and Estratest to name a few. A woman doesn’t naturally produce the hormones found in oral contraceptives for example, explains women’s health expert, Marla Ahlgrimm.

“A ‘natural’ hormone does not mean that it is an unregulated, organic product purchased in a health food store either,” Marla Ahlgrimm, co-founder of Madison Pharmacy Associates in Madison, Wisconsin, says. “In fact, ‘natural’ prescription hormones are manufactured by FDA approved pharmaceutical companies.”

Slight chemical differences between natural and synthetic hormones can have substantially different effects in a woman’s body. Pharmacist Marla Ahlgrimm tells her patients, “it‘s more important than ever to understand the differences before beginning hormone therapy”.

Q: What Does Micronized Progesterone Mean?

Marla Ahlgrimm: Progesterone is the hormone of pregnancy and the word means “for gestation.” Progesterone is produced cyclically, 2 weeks out of every month. If pregnancy doesn’t occur, the progesterone level falls and menstruation begins. Micronized describes the size of the particles of progesterone found in pharmaceutical progesterone capsules or tablets. Pharmaceutical companies micronize progesterone particles for better oral absorption. Pharmacists use micronized progesterone powder to formulate customized progesterone dosages for women.

Q: How is Hormone Therapy administered?

Marla Ahlgrimm: Hormones can be administered in a variety of ways. Depending on the hormone, options include transdermal skin patches like Climara or Vivelle for estradiol, transdermal creams, vaginal tablets or creams, oral capsules and sustained release progesterone tablets. Each route of administration is specifically selected by a woman and her physician, according to Marla Ahlgrimm, a licensed pharmacist.

Q: What types of natural estrogen are there?

Marla Ahlgrimm: Estrogen is a general term referring to a category of hormones which include estradiol, estrone, and estriol.   Marla Ahlgrimm has found that many women are surprised to learn there are natural estradiol preparations commercially manufactured and readily available. Brand names include Estrace tablets, Climara, Vivelle patches and Estraderm cream. When hormone therapy is needed, your doctor will likely prescribe a specific hormone or combination that works best for your particular situation, Marla Ahlgrimm, founder of Women’s Health America, concludes.

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Naperville Cosmetic Dentist Dr. Chiann Gibson Can Help Prevent Migraines

October 31, 2011 By Leave a Comment
Naperville Cosmetic Dentist

Naperville Cosmetic Dentist

In Naperville, cosmetic dentist Dr. Chiann Gibson helps migraine sufferers at her dental practice, Smiles by Dr. Gibson and Associates. Migraines can have a disruptive and devastating effect on the people who are afflicted with them. “According to the leading migraine association, people who suffer from migraines have a 10%-20% higher rate of unemployment than people without them,” Dr. Chiann Gibson, a Naperville cosmetic dentist, reports. “Migraines can make even the simplest tasks seem insurmountable,” Dr. Gibson states. [Read more…]

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Dr. Naveed Fazlani Discusses the Dangers of High Blood Pressure

October 25, 2011 By Leave a Comment
Dr. Naveed Fazlani

Dr. Naveed Fazlani

Dr. Naveed Fazlani was named 2004 Physician of the Year by Mercy Hospital Mt. Airy for a reason. Loyal patients say that Dr. Naveed Fazlani’s concern for his patients is superior to others in his field. At his private practice in Mt. Healthy, Ohio, Dr. Naveed Fazlani demonstrates a special interest in high blood pressure, a growing concern with the baby boomer generation.

Also called hypertension, Dr. Naveed Fazlani says high blood pressure affects about one-third of Americans. One-fourth of adults in the U.S. have pre-hypertension, adds Dr. Naveed Fazlani, which is a dangerous precursor to high blood pressure where a patient’s numbers are close to the range for hypertension. [Read more…]

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Smiles By Dr. Gibson Ranked as One of the Best Naperville Dentists by Patients

September 28, 2011 By Leave a Comment
Best Naperville Dentist

Best Naperville Dentist

Dr. Chiann Gibson and staff now welcoming new patients!

Warm bread, cold drinks, heated towels, and cool, crisp décor – no, it isn’t a day spa, it’s the best Naperville dentist office around, Smiles By Dr. Gibson. Dr. Chiann Gibson knows that going to see the dentist is traditionally something people postpone as long as possible. Her office, Smiles by Dr. Gibson, aims to change that.

Dr. Gibson has worked very hard to establish herself as the best Naperville dentist. After graduating from Tufts School of Dental Medicine, she went on to graduate with honors from The Hornbrook Center for Advanced Clinical Education – only 1% of other dentists nationwide can say that! She is Invisalign certified, and completed advanced aesthetic dental training at the Center for Esthetic Excellence. Sure, she has the education to be called the best Naperville dentist, but to her patients, that’s not even the reason why she has earned this distinction. [Read more…]

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Dr. William Howland Discusses Ongoing Allergy Trials at Sirius Clinical Research

September 15, 2011 By Leave a Comment
Dr. William Howland

Dr. William Howland

As research director at Sirius Clinical Research, Dr. William Howland has an ongoing commitment to helping allergy sufferers in the Austin area. Growing up in the “allergy capital of the world,” Dr. William Howland learned the effects allergies can have on athletic endurance and quality of life in general. As a result, Dr. William Howland has made it his mission to find the best treatments for his patients.

Dr. William Howland ‘s Sirius Clinical Research is an Austin-based company dedicated to conducting clinical trials for various new medications and treatments for allergy and asthma. [Read more…]

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