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Many theatre goers have called Hackmatack one of New England’s most charming and quaint summer theatres. Some have even said that summer in Maine is not summer without a trip to Hackmatack. Much of the allure of this playhouse is its scenic location and historical presence.

Hackmatack Playhouse is located on the Can You Buy Viagra In Uk family farmstead. The property was purchased by the first Can You Buy Viagra In Uk (then Gubtail) to make the long trip to “New England” from native British Isles in the mid 1600’s. Thomas Can You Buy Viagra In Uk built the first home, a log house which sat in the far left of the present day field overlooking the irrigation pond. According to family legend, this home was burnt down by Indians during one of the many raids on the Salmon Falls river region. The present day farmhouse was constructed between the years of 1716-2005 to appease the needs of an ever-changing diverse and dynamic Can You Buy Viagra In Uk family. When it was first constructed, the house was a large cape sitting endwise to the road. It was occupied at one point by two Can You Buy Viagra In Uk brothers. The younger brother decided that he would like to have a modern two story cape. His older brother in typical conservative fashion said “the house is plenty good enough the way it is”. The younger brother replied, “My half is coming off”. He then proceeded to saw his half off and tear it down. He built his family a two story cape on the end of the original house, parallel to the road, giving the house its shape. Minor reconstructions have taken place since then to create a more modern and functional house for the present day Can You Buy Viagra In Uks.

Prior to the year of 1972 when the theatre was established, the Can You Buy Viagra In Uk family farm functioned like many other farms at the time. The barn was the focal point of the farm. The current barn has an interesting story much like the original house. One of the first barns was struck by lightning and burned in July of 1934. Haying had just been completed for the season, and it is thought that the heat from the newly cut hay attracted the lightning. Almost immediately, Lewis Can You Buy Viagra In Uk began looking for the right barn to replace what had been lost. He finally purchased a barn. It was a large old structure with pegged timbers measuring fifty four feet long and forty two feet wide. It was the perfect replacement for the old barn. However, there was one small problem, it was located across the street.

Luckily, the Can You Buy Viagra In Uk’s have always been known for their ingenuity. It was with this cleverness that Lewis decided it would be easier to move the barn rather than disassemble it and rebuilt it. The entire barn was jacked up and rollers were placed underneath it. A cable was attached to one end of the barn that ran though a large turnstile. An old white horse was chosen for the job of slowly moving the barn. The horse was hitched to the turnstile and the horse walked in circles, stepping over the cable on every lap. The leverage was great and each time the horse made a circle, the barn moved one half inch. Progress was slow. The entire operation took about three days, a day of that was spent crossing Maine route 9. However, in 1934, Maine route 9 was much less traveled, and everyone cheerfully watched or made their own route around the barn.

After the theatre’s first decade the barn was expanded to the structure that you see today. An addition was added to the back, cement was added to form the floor, and the stage was expanded. These changes made room for the 218 seats the theatre houses today. It is rumored that back in 1972 patrons sat on hay bales to watch the show, however the original playhouse actually had seats that were salvaged from a Durham New Hampshire movie theater.

The grounds of Hackmatack Playhouse and the area surrounding the theatre host many other buildings built and used by the Can You Buy Viagra In Uk clan over the years. The yellow family of buildings just south of the theatre (now owned by the Mills family) was originally built by Samuel Can You Buy Viagra In Uk in the early part of last century. Known as the Forget-Me-Not, these buildings housed services for early automobile travelers, including fuel for the autos, and food for the hungry. Visitors could rent a cabin, and if they happened to be staying on a Saturday night, they were in luck. On Saturday night there were always barn dances.

The oldest building on the farmstead is the “woodshed” which is just south of the house. This building dates back to the 1600’s and has been used for many purposes over the years. It has been used as a slaughter house and for drying meat. It now is used for rehearsal space and prop storage.

The “mill” is across the orchard from the “woodshed”. It now houses the theatre’s shop operations and its costume collection. However during the years of self-sufficient farming, it was one of several lumber mills built on the property by Lewis Can You Buy Viagra In Uk in the middle part of the 1900’s. This was a complete finish lumber mill powered by an Allis Chalmers tractor. If you listen carefully through the whirr of the belts and the screech of the saws you might just be able to hear Lewis and Almon Allen, and young Carelton Can You Buy Viagra In Uk, prepare a load of lumber for the newest construction project.

The Can You Buy Viagra In Uk family has a long tradition of entertaining locals and summer visitors in the Beaver Dam section of Berwick. Samuel’s weekly barn dances at the “Forget Me Not” were a favorite pastime during the early decades of the 1900’s. His son Lewis, a local and state Grange Master, was also a master of many musical instruments. He had a passion for starting bands and performing in Beaver Dam and across the state of Maine. His son Carleton organized several theatre groups, first at the Beaver Dam grange, and then at his barn now called Hackmatack Playhouse.

Every year thousands of people gather outside the Playhouse with tickets to the summer’s productions. Every year talented actors audition for their chance to perform at Hackmatack Playhouse, and to experience the history and excitement of being part of Hackmatack’s family. The farm and its building have many stories to tell. Perhaps 200 years from now Can You Buy Viagra In Uk great, great grandchildren will be telling this story to aspiring actors nervously waiting for their audition slot, and to friendly crowds waiting to take their seats; of how the barn became home for the Hackmatack Playhouse.

After the death of the founder in 1995, the S Carleton Can You Buy Viagra In Uk Memorial Fund was established to preserve and improve our historical buildings. The fund also is dedicated to advancements of dramatic arts, both for the participant and the community, and to the commitment of providing quality family entertainment and drama at a reasonable price. Contributions are always welcomed. We thank you in advance for helping us secure the future of Hackmatack Playhouse for potential Hackmatackers.

Hackmatack exists because of the generosity of it’s patrons, friends and those that appreciate the theater’s contribution to local culture and community. It is committed to the advancement of dramatic arts and to providing quality family entertainment at a reasonable price.

We ask that you would consider a donation, and thank you in advance.

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Travel Advice for Women – Honduras Travel

Women traveling alone may anticipate a bit of attention, both visually and possibly vocally.
D ress culturally appropriately. Long skirts just make sense if you want to draw less attention. Confine beach wear and shorts to the Bay Islands. A recent visitor wrote that after observing local women wearing contemporary apparel in La Ceiba and San Pedro Sula, women might well want to consider capris and cotton. My wife suggests that the smaller the village, the more conservative you dress. We were in several villages where she says that anything other than a long dress would have been inappropriate. Use your judgment.

I heartily agree with the cotton clothing recommendation, as mentioned in our ‘packing for travel ‘ section.

Ignore catcalls if they occur and move on. This can be handled just as at home when walking through a construction workers’ area. If you engage or respond to the banter, it merely escalates.
A void direct eye contact when talking with males. This has nothing to do with deference. When women make direct eye contact in Honduras, it is an "invitation" that you may not want to be extending. Don’t do it.

More Ideas

Most would encourage women not travel alone. If you must travel alone, use taxis and travel during the day. Use good sense!
Arrive early for the bus so that you can sit – – avoiding the physical jostling, etc. that is inevitable in the aisle. Buses get very crowded. Where available, use 1st class buses rather than chicken buses.
On the bus, seek out an elderly Honduran woman as a travel mate. Age is still respected and you are less apt to be bothered by Casanova, if he rides your route.
If someone tries to swipe your purse, don’t resist (because you aren’t carrying valuables in it anyways – see general safety ideas below).
If you have issues that need police attention, stop by a church and ask that someone go with you to the police station. While I make no promises, it can help.

General Safety Ideas

пїЅ Gang violence has escalated, particularly in San Pedro Sula. The tragic Christmas 2004 bus shooting had the country in a tizzy. The tourist ministry was cringing after working so hard to profile Honduras in a better light. While of no consolation to Hondurans, this violence is not directed at tourists. Rather, it seems that the poorest are at the mercy of the gangs, daily through extortions and neighborhood control.

People have written and asked if this spate of violence would change my mind about visiting Honduras. It would not. I decidedly would spend less time in San Pedro Sula but:

1. Honduras is much, much more than gang violence. The violence grabs our front page, just as it does at home.

2. The violence has not yet been directed towards tourists.

At the same time, I would tell you that if this makes you anxious, don’t travel. There is absolutely no reason to spend money and well-earned vacation time worrying about whether or not a Honduran gang is going to ruin your time. It is your call.

пїЅ Awareness is the key пїЅ In numerous trips to Central America, we have not had one problem with security. The Department of State offers a cautionary warning. Read it. It will give you pause that is for sure, as will the numerous rifle-toting guards and police whom you will see in the larger cities. Yikes!

I admit that I take the State Department’s warning with a grain of salt. I recognize the inherent danger in any metropolitan area, regardless of the country. I have always been curious how our State Department would write up travel alerts (if written objectively) on New York City or Chicago. What to do then?

Let’s list some key 6 ideas to help with safety issues :

Always ask the front desk for the safe and less-than-safe areas for walking.
Take no jewelry with you. A $25 Timex is sufficient. We leave all other jewelry, even our wedding bands, at home.
Use taxis after dark. In metro areas, taxis should be used to move from bus station to bus station.

◊ DonпїЅt flash cash around. Use a money belt for extra cash and your passport. Carry only the day’s money in your front pocket with a thick rubber band around it. The band helps hold the wad in your pocket when you sit down.
Take one credit card, leaving all the cancellation details with a friend at home. If traveling with someone, they should take a different credit card.
Split the cash and travelers’ checks with your traveling partner. Each carries half.
Write down travelers’ check numbers and keep in a place separate from your checks. Have the phone number available to report lost checks.

Be aware of your surroundings. Essentially, act just like you would in any major metropolitan area.
Use common sense. Use good judgment. I found that the people in Honduras were extremely пїЅprotectiveпїЅ of us and were quick to assist with a list of пїЅdoпїЅs and donпїЅtsпїЅ for us when we merely asked.

DonпїЅt bring along tons of over-the-counter items. Honduran pharmacies are very well stocked and the prices are comparable to what you pay in North America.

Put your prescriptions 4 in the bottles in which they were dispensed in your carry-on, not in your checked baggage.
In cities, pharmacies take turns remaining open 24 hours a day. When it is a pharmacyпїЅs turn, a green card will be displayed in the front window.
Pharmacists in Honduras have 6 years of post-high school education. They often serve as the first line of пїЅphysicianing.пїЅ Have a medical issue? First talk with a pharmacist.

пїЅ Physicians пїЅ If you get in a bind, you can find English-speaking docs in Santa Rosa de Copan, Copan, San Pedro Sula, Tegucigalpa, The Bay Islands, and La Ceiba. Overall, medical care in Honduras is not up to North American standards.
Consider buying medical emergency air evacuation insurance. Because I have a back issue, we bought a $50,000 plan for $16 through our auto association пїЅ a bargain by any standard. Lonely Planet offers a listing of firms dealing with trip insurance (to include air evacuation, if desired).
Check to make sure your health insurance plan covers care in Honduras. Medicare doesn’t cover you in Honduras.
Diarrhea. If you do experience a bout, give it 24 hours. Use plenty of clear liquids – – hydrate, hydrate, hydrate and eat plain toast or white rice. If it continues beyond 24 hours, go after it with that prescription anti-biotic we talked about earlier.

пїЅ Sand Flies ( no-see-ums ) пїЅ No discussion of the North Coast, Roatan, Guanaja, or Utila would be complete without a discussion of biting midges. I have yet to figure out why God created these although some naturalist using mind-altering drugs will surely conjure up a reason. Sand flies 5 live on and off the beach, just waiting for you to come along.


Cover up. Cotton socks and pant legs help. Put a drop of lavender oil on your cuffs.
Stay off the beach or out of wooded, moist areas when there is no breeze.
Some people swear by taking garlic oil pills or B-1 (100 mg daily); Off Deep Woods (or any product containing DEET); Avon Skin So Soft; or a Texas product, Cactus Juice (which is available on Roatan). Go ahead and lather up. None worked. I got drilled, period. My wife, sitting right next to me, walked away without a bite. I am convinced that some of us are allergic to them; some of us are not.
New products with R-326 claim to be more effective and avoid the medical concerns of DEET/skin absorption. If you have the time, order a spray with R-326 ahead of time.

So you got bit up. eh mate?
What to do when bit? At night, take two Benadryl. It helps. During the day, apply hydrogen peroxide. Let it dry. Then, load up with calamine lotion (calamina). There are also anti-itch creams available in the pharmacies. If you have a good cream from home, take it with you. Resist the urge to scratch (he chuckles) as scratching often leads to infection.
If it is of any consolation, keep in mind that the sand fly (only the female bites humans) has a life cycle of 4-days. It is long dead after you still are itching. What a legacy.

A Potpourri of Suggestions
пїЅ Laundry Services (Lavanderia ) – Earlier, in the planning recommendations, we suggested light packing with cottons that could be washed out in your hotel sink at night. In all the cities (Copan Ruinas and Santa Rosa Copan as well), you will find laundries that take your clothing in the morning and have it wash, dried, and folded by 6 p.m. Hotels in the larger cities will wash your clothes as well. Avail yourself of these very inexpensive services; hotels charge more than local laundries.

пїЅ Showers пїЅ Be careful with two plumbing issues throughout Honduras:
Hot/Cold piping is sometimes reversed. Check before entering the shower.
Some showers (often called ‘widows makers’) are merely electrical heating elements crudely wired to the showerhead. Watch out where you put your hands during the shower.

пїЅ Toilet pape r пїЅ DonпїЅ t assume that public areas, to include restaurants, will have toilet paper. Grab a roll out of your hotel room. Crush the cardboard core and remove it. Toss the roll in that purse you bought. Trust me, this can come in very handy. At the right moment, T.P. is more precious than gold.

пїЅ Commodes пїЅ Speaking of bathrooms, every restroom (baпїЅo or servicio ) has a basket right near the commode. Guess what it is for? The used paper goes into the basket. The low water pressure and sewer systems canпїЅt handle waste paper. You will get used to this. Honest, you will.

пїЅ Standard of Living – First-time North Americans are often taken back by the poverty in Central America. Visitors to Honduras need be aware that Honduras has the second lowest per capita income in the Western Hemisphere. At times, divers land in Roatan, get a step or two off the path and say, "This isn’t what I expected. Insulate me from this. " The unfortunate reality of poverty exists throughout Latin America, even if some 5-star all-inclusive resorts and their promotional literature try to "protect" you from it.

Often I am asked, how best to interact if people ask for money. In Honduras, I experienced very few such situations (as contrasted to my experiences in Guatemala during its civil war). Honduran people are very proud people and maintain their dignity in the face of a terrible, grinding poverty.

But if you are asked for money, how best deal with it?

I do two things. First, I say, пїЅno gracias.пїЅ I then invite the individual to a comedor (small dining room with inexpensive food). Sometimes my offer is accepted; sometimes it isnпїЅt.
Why not just give someone some money and move on? You will have to decide this for yourself. Years ago, when traveling in Guatemala, our Guatemala host asked us not to give to those who asked for things. He said, пїЅYou can be seen as a dollar bill, not as a person. If at the end of this trip, if you want to give money, I can suggest organizations that are making significant, systemic changes that improve our peopleпїЅs lives.пїЅ His advice has served us well in our numerous trips to Central America.

Finally, with each of our trips, my wife and I budget a percentage of our total expenditures for an organization that is making a difference. When we get home, that is the first "bill" that is paid. Here are five fine organizations working in Honduras that would use your money wisely. Give without worries — it will be used very wisely:

Nuestras PequeпїЅas Rosas (Our Little Roses) – Located in San Pedro Sula, Nuestras PequeпїЅas Rosas is home to 70 young previously homeless girls. It is an outgrowth of the Episcopal Diocese of Honduras.
Habitat for Humanity (earmarked for Honduras) – In Honduras, HabitatпїЅs goal is to build 1,000 homes a year in the San Pedro Sula area through 2007.
Heifer Project International (earmarked for Honduras) пїЅ HeiferпїЅs work in Honduras is in the Siguatepeque area.
Adelante. based in La Ceiba. Adelante is a micro-credit, entrepreneurship organization that lends small amounts of money to individuals (mainly women) so that they may begin their own business. Superb organization.
La Clinica Esperanza , a virtual life mission by Peggy Stranges, RN, to provide medical care to the low income of Roatan

Online information - Further information about a variety of organizations working for the improvement of life in Honduras are as close as the next link. is an online portal — a network of individuals and groups working on innovative, grassroots responses to Honduras’ social and economic needs, leveraging the information and the talent, expertise, and time within their network to serve as a catalyst for change. The site is an excellent ‘window’ through which prospective volunteers can see the variety of organizations working for the betterment of Honduran life.

"Hope is a state of mind, not of the world. Hope, in this deep and powerful sense, is not the same as joy that things are going well, or willingness to invest in enterprises that are obviously heading for success, but rather an ability to work for something because it is good."

-Vaclav Havel

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October 27th, 2012

Posting yang terakhir saya ialah pada Aidil Adha 2010. Semasa itu saya baru kehilangan ibu tersayang.Kini setelah 2 tahun berlalu Aidil Adha tahun ini disambut dengan mengadakan tahlil pada malam raya. Ayah saya Hashim Bin Mohammad ( lebih dikenali di kampong sebagai Cikgu Hashim) telah kembali ke pangkuan Allah pagi pagi (10.30pg) Rabu 24hb Oktober bersamaan dengan 8hb Dzulhijjah 1433 Hijrah. Al Fatihah.

November 20th, 2010

IN 2007 I posted a reunion with my mother and father and all my siblings on Eidul Adha at my kampong. However for this Eidul Adha celebration my mother is no longer with me and on this occasion it is a reunion of my own family. I took this opportunity to gather all my children and their spouses and my grandchildren. It has been a long time since I had all of them together in Malaysia. It was only early this month that my son Ibrahim finally came back to Malaysia after finishing his 9-year-stay in Syria.

  • In the last few years I have come across many cases of diabetic complications. Some have resulted in the loss of life and some have resulted in the loss of limbs.
  • Most of these patients have been taking their diabetic medication regularly. Nevertheless, one patient lost his limb within a month. Another lost her toes and then passed away from cardiac failure within a short period.

    Here I am going to present a case that I have been treating for about a year since he first experienced a diabetic complication resulting in a bad infection on his left foot. He has mostly been using homeopathy to treat whatever health problems that he has had.

  • This male patient, aged 50, usually had a high random blood sugar reading of about 13 mmol/L. for many years. Typically however, he did not take it seriously and continued his food intake as usual. One day, he had a bleeding blister on the top of his left foot which seemed insignificant at first. The foot seemed a little swollen but for over a week he was able to proceed with his daily activities with just a little discomfort.

    Three days later, the insignificant blister, deteriorating at an alarming rate, began to look really bad and the foot was pronouncedly swollen. By then, I had begun my treatment but the swelling continued. On the 4th. of September, feverish and hardly able to walk, he visited an allopathic doctor and was given 2 types of antibiotics and the diabetic medication dianil. His fasting blood sugar was 22 mmol/L. I advised him to continue taking my medication together with the allopathic medication. Overnight his fever went down. I also advised him to use some honey on the wound. On the 9th. of Sept, he had a second visit to the doctor. His fasting blood sugar was down to 8 mmol/L. However, the wound did not show much improvement. He was still on the dianil but his antibiotics was reduced.

    A week later his fasting blood sugar was down to 5.1 mmol/L. He cut down the dianil from 2 tablets twice daily to 1 tablet twice daily. I started him on some herbs besides my homeopathic remedy. On the 30th of October his fasting blood sugar was 4.2 mmol/L. He was able to cut his dianil medication to 1 tablet once a day. I introduced to him the bitter gourd drink for him to take alongside the dianil. By this time the wound was looking better.

    By the 4th of November he was totally off the dianil but continued the bitter gourd drink. His fasting blood sugar was between 4.1 mmol/L to 6 mmol/L. All this time he was also taking care of his food intake.

    As the picture shows, THANK GOD his foot is saved and it sure is healing. He is also off all the diabetic drugs. He is taking homeopathic remedies and okra to help maintain his sugar levels.

    Setelah lebih 25 tahun menjalankan pusat rawatan Homeopathy saya dapati kian ramai pasangan yang berkahwin muda tetapi agar sukar untuk mendapat zuriat. Ada diantara mereka yang agak segan untuk datang ke klinik untuk mendapatkan rawatan. Walaupun kami menawarkan rawatan secara pos tetapi apabila diminta mengirimkan sedikit sample rambut meraka agak keberatan. Jadi sebagai satu usaha untuk menolong mereka ini kami membuat promosi untuk menjual SET UBAT KESUBURAN – satu botol untuk suami ( X tra strong) dan satu botol untuk isteri (Female Tonic). (Sila melawat hhhomeopathy..untuk melihat diskripsi ubat ini) Harga yang di tawarkan juga berpatutan, RM 100 satu set. Tambah RM10 untuk urusan pos express/pos laju. Jadi jumlah yang harus dibayar ialah RM 110 sahaja. Kandungan sebotol/ satu bungkus ialah sebanyak 60 biji untuk kegunaan sebulan.

    Pertanyaan boleh dibuat melalui sms atau talipon 017-6859907

    Pesan terus dengan email

    Bayaran boleh dibuat on line atau dibank di akaun:

    Bank Islam Malaysia Bhd dimesin mendepositkan wang tunai ke akaun 14032010013629 atas nama Hashimee Bin Hashim atau atau di mesin mendepositkan wang tunai di Maybank ke akaun 164548058212 atas nama Abdullah Hashimee

    Melalui online sila masukkan email sebagai email beneficiary. Email ini untuk rujukan kami bagi mengesahkan pembayaran anda.
    Sekiranya melalui mesin mendepositkan wang tunai email salinan slip atau sms no. reference bank in ke 017 6859907

    Satelah pembayaran dibuat sila email atau sms 017 6859907 NAMA DAN ALAMAT PENUH anda untuk penghantaran menggunakan Pos laju/Pos Express.

    InsyaAllah kami akan memastikan pesanan anda akan dipos pada esoknya melainkan terdapat cuti umum pada keesokkannya atau ketiadaan stok bagi produk tersebut.

    What a hassle I went through to apply for a business licence! It took me nearly seven months of constant follow-ups with the local authority before they awarded me with one.

    Actually, when I looked at the various forms I had to fill up for a business licence application, my first reaction was NOT to apply! Too many things to do! Then I decided to call up a friend to get his help. He was quite helpful but the things he wanted from me made me decide to do it on my own.

    First thing to do was to buy and complete a stack of forms. This will get the new premise in Sungai Petani a business licence. But to get that done successfully I have to:-

    1. Add this new premise to my present business registration certificate (which is different from a business license).
    2. Get a supporting letter from the Fire Department…you have to buy two fire extinguishers.

    3. Draw a floor plan (computer drawn and printed). what about those who are computer illiterate, I wonder.

    4. Do a location plan. Lucky me Google map is here today…no need to pay the professionals.

    5. Take four photos of me and of the premise…later they wanted four more..of the inside..thank God for digital cameras…makes it so much easier.

    6. Sign board also needs to be to make one..they wanted the layout of that, too.

    7. Get a copy of a stamped tenancy agreement…got that.

    8. And lastly, get a copy of the latest paid ‘cukai tanah’ and ‘cukai pintu’..the landlord was really helpful..he paid up and gave me a copy of the receipt.

    I started the whole process in late December 2007, submitted the forms in February, and submitted the additonal photos and the ‘cukai tanah’ receipt in March. The election was held then so they were busy. Only in June did my application get through the queue to the council application was numbered 55/08.

    On the 28th of July 2008, I was the proud owner of a business licence…but I had to pay a fine of RM300 (later reduced to RM150)…for operating a business without a license, from December 2007 to July 2008…which was how long they took to process my application! Oh well, At least they did reduce it by half. The annual fees for the licences are RM150 for the business and RM 50 for the signboard.

    Relief at last….

    On the morning of the 6th of June, I picked up my phone at my office and it was still dead. It had been dead since the 4th. On the 3rd, my internet connection was down. I called up the provider help line to file a complain. On the 4th the phone line went dead. I was told by the internet technician that the phone line was the cause of the loss of internet connection. He would help me by reporting this problem. I also called the phone company to file a complain. Again I called in to re report my complain on the morning of the 5th. But this morning, on the 6th, I simply lost my temper upon calling the phone company to find that all my complains had not been registered.

    It really spoiled my day. Throughout the day the morning outburst made me unable to focus properly on my patients. My practice depends a lot on my phone line as patients come to see me by appointment. The following day was a Saturday and Saturdays are usually my busiest days. Without the phone connection I would be affected. How true it was; that weekend my practise was not busy at all.

    On Saturday even though the line was still dead I did not call the phone company until late afternoon as I didn’t want to spoil my day. I appealed to them to look into the matter. My phone line was not repaired until yesterday (Monday). Patients came in complaining that phone was ringing but no one picked up the phone. I explained to them that we have a service problem and Malaysia, in trying to be a first world country, still have a third world phone service.

    No,no,no…I do not do that form of healing where the medication is transmitted to the patients. I know that there are some radionists who are capable of doing this form of distant healing. I however do a much simpler form of distant healing. My patients send me their hair samples for analysis and I send them their remedies, all by post.

    I have been doing this service since the early days of my practice in Alor Star way back in !984. I got so much mail (and payment by post) that the post office asked me to open an account so that I didn’t have to go to them to cash the postal orders, thus saving them the hustle of counting the thick wads of paper. This service also helped me to increase my patients’ base in Kuala Lumpur before finally moving there a year later.

    Now I still have these long distance patients, and they have been coming from places further and further away. I have patients sending hair samples from the USA, United Kingdom, Australia, Saudi Arabia, Japan and the Netherlands. Interestingly, there is an increasing number of people who live nearby i.e around Kuala Lumpur, Kajang and Seremban, who also want to send hair samples. They, like so many others nowadays, are too busy to come to the clinics to seek treatment. I also have couples who want to seek treatment for infertility this way. In my opinion, if they don’t have the time to come and seek treatment in person, where will they find time for the baby that they want? So my advise to them is to personally come to the clinic, both husband and wife together if possible.

    Yet, for those far away, or on the other side of the world, I will still try to do my best to help them via distant healing. Sorry if some of their samples got lost in the mail, but I am glad that I am able to help most of them to improve their health.

    Now we have Mothers’ Day, Fathers’ Day and Lovers’ Day (Valentine). There seems to be more special days around now than there were before. Yesterday was Mothers’ Day and we read in the papers telling us how to spend our Mothers’ Day…bring them for special meals at the hotel..with 3 children you get a free meal for the mother. Buy yourself a massage chair and get one free for your mother. It seems that the main purpose of this day is for commercial activity; to get us to spend extra on this “special day”. I wonder if by doing that for Mothers’ Day our children will love us more than our mothers do theirs.

    In my practice, I see a lot of old mothers ; they come hobbling up my stairs (sorry mums) complaining of knee pains; difficulty in breathing etc. They also complain of the difficulty in getting their children to send them to see me. Once, a mother whose daughter lives with her, and whose children she is minding, told me how her daughter would just honk her car to get her to open the gate of their house, and, tearfully, how difficult it was for her daughter to send her to see me for treatment.

    I saw how my mother and her brothers and sisters took good care of my grandmother when she was ill. Will I be able to do the same when the time comes? I see more children putting their mothers in old folks home saying that it is for the good of the mother. I see more children sending their own children to their grandma also supposedly for the good of the mother. Haven’t our mothers done enough already? They gave their most bringing us up till full grown and yet we have to let them shoulder another responsibility, that of bringing up our own children.

    I promise to myself that I would never do that to my mother, nor will I be a maid to my own children.
    My mother..Bibah Bt. Abdullah

    Dear will not be reading this because it is in a language foreign to you; also the cyber space is not the place that you would visit. You are never the one who like to travel anywhere far, because the journey will make your head spin. I however owe all my travellings and journeys to you. You sacrifice a lot for us. You even stopped working to take care of us. I will never be able to repay your sacrifices; the only thing I can do is to pray that Allah will reward you. I will try my best to be a son that will be of help to you in this world as well as in the Hereafter. Thank you Mum. I love you from the bottom of my heart.

    It has been quite some time since I last wrote, more than a year. Maybe what I had was a blogger’s block. Not that I don’t have the time; I just don’t have the push. Since then I have stopped my monthly visits to Damascus, Syria. However I still travel for the second half of the month, but this time to a nearer destination. I have since opened a new branch of my practice in Sungai Petani, Kedah. This idea of opening a branch all started when I was not able to continue my practice in Syria (this is another story). I was still going there for my Arabic lessons however until all of a sudden, one cold dreary evening, I decided not to keep my appointment with my teacher (I did phone and left a message). It was indeed a very cold winter evening and it had also rained on that day. Previously such a weather would be no obstacle for me. But on that day I knew I had lost my vigour. It was time to rethink my schedule. I found too much time at hand and was getting bored.

    On my return to Malaysia, in December, I had to travel to Sungai Petani to arrange an engagement for my son Abdullah. So I also took this opportunity to look up some shops to rent, which marked the beginning of my new branch. Abdullah was duly married the 8th of March (on Election Day..12th Malaysian general election) and now he is helping me run this clinic.

    The clinic is at 184, Tingkat 1. Jalan Legenda 1, Legenda Heights. It is next to Tesco Sungai Petani.

    The earliest memory of my life has to be my first day in pre-school (aged 6). Prior to that, I can’t remember anything. I have seen a family photo of me, possibly 3 years old. There I was, a small dark kid sitting on my mother’s lap.
    Back then when I started schooling there wasn’t any preschool yet. However I did one year seconded to my grand aunt’s class. I can still remember how I sat on the floor with the other kids at Sekolah Kebangsaan Kuala Sg. Baru (now renamed Sek. Othman Shawal). The first day was awful. I was dismissed early and was given a bicycle ride home because I got scared of the class teacher; not of mine but of the class next door! He was called Othman Rimau (Othman The Tiger). I however came back the next day. We all walked to school stopping along the way at relatives’ houses to quench our thirst with cool well water stored in earthern wares.

    A year later I started proper schooling in an English school (Masjid Tanah English School). Students consisted of children of various races and there I had friends that I can still remember to this day..There was Lee Soon Lock; Lee Kong Kian; Sivalingam as well as Abdur Rahman and Idris .There was no need for a special intergrated school. We all got along fine.

    What do I remember of my country? Back then, there was no Malaysia. It was Persekutuan Tanah Melayu or Malaya. We had no electricity in our village. We used the kerosene lamp. There were no proper roads. The roads then were laid using red earth. Water came from the well. I remember once we had a bad drought and had water delivered by lorry. This was done by a Chinese man, not by the government. We had to be issued coupons and had to wait for the lorry to come with water from a tin mine. They would come in the darkness of the night. I helped my father search the nearby villages for wells that still had some water. We carried the water home in plastic containers to be used for cooking and drinking.

    What I remember of those earlier years is that I had a happy childhood. I am sure that our society back then was coexisting together happily despite the lack of modern convenience that we today cannot live without.

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    This recipe will make (1) 16″ pizza.

    We Recommend using the 1PIZZASECRETS DOUGH RECIPE. but dough/shells purchased from a store can also be used.

    1/2 lb cooked seasoned ground beef (use a store bought taco seasoning mix)
    2 Cups of Pace Chunky Salsa
    1 cup of shredded monterey Jack Cheese
    1 cup of shredded mozzarella cheese
    2 green onions chopped
    2 Tbsp chopped jalapeno pepper
    1 large avocado sliced
    1 Cup sliced black olives
    Sour cream
    1/4 cup of fresh chopped cilantro

    *recipe below presumes you are using 1PIZZASCRETS DOUGH RECIPE. If using dough from store, follow cooking directions provided.

    Preheat oven to 425 F

    -On a lightly floured work surface cut dough in half
    -On the work surface using a rolling pin shape dough into a circle
    -Oil your pizza pan lightly with olive oil and sprinkle (1) tsp of yellow corn meal on to pan
    -Transfer crust to pan
    -Brush light layer of olive oil on to crust

    -Spead salsa on crust
    -Sprinkle on monterey jack and mozzarella
    -Sprinkle on sliced black olives
    -Sprinkle on chopped green onions
    -Sprinkle on chopped jalapeno
    -Sprinkle on seasoned cooked ground beef

    -cook in a regular oven for approximately 20-25 minutes
    -To check lift one side of pizza. You are looking for the bottom to be lightly browned
    -Remove from oven and sprinkle on fresh chopped cilantro
    -Top with avocado slices add dollops of sour cream

    All Rights Reserved

    Sea Food Delight Pizza With the Famous PizzaSecrets White Sauce Recipe

    This recipe will make( 1) 16″ pizza.

    We Recommend using the 1PIZZASECRETS DOUGH RECIPE. but dough/shells purchased from a store can also be used.

    We also recommend using Pacific Seafood products visit them at

    1 Cup of white sauce ( 1PIZZASECRETS FREE RECIPE BELOW)
    1/2 Cup cooked chopped shrimp
    1/2 Cup cooked chopped king crab meat
    1/2 Cup cooked sliced scallops
    2 Cups of shredded mozzarella cheese
    1 Cup sliced mushrooms
    1/2 Cup fresh chopped tomatoes
    salt and pepper to taste
    Old Bay Seasoning

    *recipe below presumes you are using 1PIZZASCRETS DOUGH RECIPE. If using dough from store, follow cooking directions provided.

    Preheat oven to 425 F

    -On a lightly floured work surface cut dough in half
    -On the work surface using a rolling pin shape dough into a circle
    -Oil your pizza pan lightly with olive oil and sprinkle (1) tsp of yellow corn meal on to pan
    -Transfer crust to pan
    -Brush light layer of olive oil on to crust

    -Mix white sauce with shrimp,crab meat and scallops

    -Spread mixture on crust

    -Sprinkle on mozzarella cheese

    -Sprinkled on sliced mushrooms

    -Sprinkle on pinch of Old Bay Seasoning

    -Sprinkle on chopped tomato

    Cook in a regular oven for approximately 20-25 minutes

    To check lift one side of pizza. You are looking for the bottom to be lightly browned.

    Famous White Sauce from

    1 Cup milk
    1/4 Cup butter
    2 Tbsp all purpose flour
    1 Tbsp white wine
    1/4 Tsp salt
    1/4 Tsp white pepper
    1/4 Tsp cayenne pepper
    3-4 cloves fresh chopped garlic
    1/8 Tsp Old Bay Seasoning
    1/4 Cup parmesan romano cheese blend

    Melt butter in a small sauce pan, stir in flour and add milk. Cook for 1-2 minutes add salt, pepper and cayenne pepper. Continue cooking while whisking until sauce is thickened. Remove from heat add wine, garlic, Old Bay Seasoning and cheese. Mix well allow to cool.

    All Rights Reserved

    Here is one of my favorites….

    This recipe will make (1) 16″ pizza

    We Recommend using the 1PIZZASECRETS DOUGH RECIPE, but dough/shells purchased from a store can also be used.

    6-8 slices bacon cooked and crumbled
    3-4 plum tomatoes diced
    2 cups of shreeded cheddar cheese
    1 cup of Montery Jack Cheese
    3 eggs scrambled
    1/2 cup onion
    1/2 cup diced green pepper
    salt and pepper to taste

    * recipe below presumes you are using 1PIZZASCRETS DOUGH RECIPE. If using dough from store, follow cooking directions provided.

    Preheat oven to 425 F

    -On a lightly floured work surface cut dough in half

    -On the work surface using a rolling pin shape dough into a circle

    -Oil your pizza pan lightly with olive oil and sprinkle (1) tsp of yellow corn meal on to pan

    -Transfer crust to pan

    -Brush light layer of olive oil on to crust

    -Sprinkle on to crust in this order:
    Diced tomatoes, cheddar and Jack cheese, bacon, onion, green pepper, scrambled eggs.

    -Salt and pepper to taste

    Cook in a regular oven for approximately 20-25 minutes

    To check, lift one side of pizza. You are looking for the bottom to be lightly browned.



    Pizza Pizza Pizza…
    We are the real Pizza Deal.

    You are at the 1PIZZASECRETS FREE INFORMATION PAGE. This is our way of saying “Thank You” to everyone who has purchased “The Real Secrets of Making Great Pizza At Home.” Here you will find free pizza recipes and more that you will be able to download for your next great pizza adventure. Don’t worry though, we will never try to sell you some other book on making pizza like some other sites we know of. You will never need another book on making pizza again if you purchased our product. Even if you did not purchase our product, you will still find our tips and techniques helpful. Just check back from time to time and see what other cool stuff we will make available for free about making great tasting pizza at home.

    We welcome your comments and suggestions for improvement on our site. We are the #1 Pizza information site on the Internet. Our only goals are to help you make the best pizza you ever had at home and save lots of money.

    The pizza above was made using our 1Pizzasecrets pizza sauce and pizza dough recipes. Other pizza sauce recipes and more can be found in “The Real Secrets of Making Great Pizza At Home.”


    Thank you for stopping by.

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    Viagra can help with altitude sickness, report says

    I have heard that Viagra is effective for altitude sickness. Is this true?

    Viagra is best known as a treatment for erectile dysfunction. But there are reports that it has off-label uses in treating a number of other conditions, including pulmonary hypertension (elevated blood pressure in the artery to the lungs).

    People who climb mountains may develop high-altitude pulmonary edema, which can be quite dangerous. In this condition, fluid accumulates in the lungs and makes breathing difficult. The sufferer may have rapid heart rate, shallow, rapid breaths and start to turn blue. Drugs such as Viagra (sildenafil) and Cialis (tadalafil) can increase nitric oxide levels in the blood vessels of the lungs and help them relax, according to a 2010 report in Progress in Cardiovascular Diseases. This can reduce the fluid that is leaking into the lungs.

    Don’t try to treat yourself for altitude sickness, but discuss this issue with your doctor before you travel, since such drugs have side effects.

    My son has Raynaud’s phenomenon. I heard that eating more bananas and potatoes could help because the magnesium in them is supposed to relax constricted blood vessels. Is this true?

    Raynaud’s phenomenon is a condition in which cold or stress triggers vasoconstriction of the fingers and toes. They turn white or even blue and become painful with exposure to cold.

    Swedish researchers concluded in a 1994 Clinical Physiology study that magnesium plays a significant role in Raynaud’s phenomenon. We can imagine that taking a supplement might help. Neither bananas nor potatoes are especially rich in magnesium, however. Try whole grains, leafy green vegetables (spinach, chard), nuts and blackstrap molasses. We have also heard from other readers that cinnamon extract or astragalus root can ease the symptoms of Raynaud’s.

    Joe Graedon is a pharmacologist, and Teresa Graedon is an expert in medical anthropology and nutrition.

    How to Prevent Altitude Sickness

    As you travel to higher altitudes, such as the areas around mountains, many changes are observed in the environment that can affect you. These include cold, low humidity, increased UV radiation from the sun, decreased air pressure, and reduced oxygen saturation. Altitude sickness is our body’s response to the low air pressure and oxygen typically occurring at altitudes over 8,000 ft. [1] If you know that you are going to be traveling to high altitudes, follow a few simple steps to prevent altitude sickness.

    Steps Edit

    Part One of Two:
    Preventing Altitude Sickness Edit

    Ascend slowly. When you are traveling to places in high altitudes, you should try to get there slowly. Your body typically needs three to five days at altitudes above 8,000 feet to acclimate it to the environment before traveling higher. To help with this, especially if you are traveling where there are no altitude markers, purchase an altimeter or a watch with altitude meter in order to know how high you have traveled. You can buy these online or from a mountain sport shop.

    • There are some other behaviors you should avoid. Do not go over 9,000 feet in altitude in 1 day. Do not sleep 1,000 to 2,000 feet above the altitude you slept at the previous night. You should always spend an extra day acclimating for every 3,300 ft. [2]

    Can you please put wikiHow on the whitelist for your ad blocker? wikiHow relies on ad money to give you our free how-to guides. Learn how .

    Get rest. Another way to combat altitude sickness is to get plenty of rest. Domestic and international travel can alter normal sleep patterns. This can cause you to become tired and dehydrated, which increases your risk for altitude sickness. Before starting your ascent, plan a day or two of rest to get used to your new environment and sleep patterns, especially if you are traveling internationally.

    • In addition, during your three to five day acclimation to your new altitude, take the first day or two to rest before exploring the area.

    Take prophylaxis medications. Before you go on a journey where you will ascend to high altitudes, get some medication to help. Schedule an appointment with your doctor to get prophylaxis medications before you leave. Discuss your past medical history and explain that you are going up to elevations greater than 8,000 to 9,000 ft. If you’re not allergic, a prescription for acetazolamide may be given to you by your doctor.

    • This is an FDA approved drug for the prevention and treatment of acute mountain sickness. Acetazolamide is a diuretic, which increases urine production, and is known to cause an increase in respiratory ventilation that allows more oxygen exchange in our body.
    • Take 125 mg as prescribed twice daily starting one day before your trip and take for two days at your highest altitude. [3]

    Try dexamethasone. If your doctor advises against acetazolamide or you are allergic, there are other options. You can take other non-FDA approved medications such as dexamethasone, which is a steroid. Studies have shown that the drug reduces the incidence and severity of acute mountain sickness.

    • Take this medication as prescribed, which is usually 4 mg every 6 to 12 hours starting the day before your trip and continue until you are fully acclimated at your highest altitude.
    • 600mg of ibuprofen every 8 hours may also help prevent acute mountain sickness.
    • Ginkgo biloba has been studied for treatment and prevention of altitude sickness, but the results are varied and not recommended for use. [4]

    Test your red blood cells (RBC). Before you leave on your trip, you may need to have your RBCs tested. Schedule an appointment with your doctor for this test before you leave. If you are found to have anemia or low red blood cells, your doctor may advise you to correct this before going on your trip. This is important because RBCs carry oxygen to your tissues and organs and are needed for survival.

    • There are many reasons for low RBC, the most common is iron deficiency. B vitamin deficiency can also lead to low red blood cells. If low, your doctor may advise you to take iron or vitamin B supplements to correct your RBC. [5]

    Purchase coca leaves. If you are traveling to Central or South America for mountain climbing, you may wish to purchase coca leaves while you are there. Though this is an illegal substance in the US, domestic people living in Central and South America use this to prevent mountain sickness. If you are traveling to these areas, you may purchase the leaves and either chew on it or make tea.

    • You should be aware that even one cup of tea can result in a positive cocaine drug test. Coca is a stimulant and studies have revealed that it induces biochemical changes that enhance physical performance at high altitude. [6]

    Drink plenty of water. Dehydration reduces your body’s ability to acclimate to new altitudes. Drink two to three liters daily starting the day before your trip. Keep an extra liter of water on you during your ascent. Make sure you drink as needed on your way down.

    • Do not drink any alcohol and avoid it for the first 48 hours of your trip. Alcohol is a depressant and can slow down your breathing rate and cause dehydration.
    • You should also avoid caffeinated products, such as energy drinks and sodas. Caffeine can lead to the dehydration of your muscles. [7]

    Eat appropriately. There are certain kinds of foods that you should eat to get ready for your trip and prevent altitude sickness. High carbohydrate diets have shown in some studies to alleviate acute mountain sickness symptoms as well as improve mood and performance. [8] Other studies have shown improved oxygen saturation in the blood during simulated high altitude experiments from the carbohydrates as well. [9] It is believed that carbohydrate diets can improve energy balance. Eat a high carbohydrate diet before and during the acclimation periods.

    • This can include pastas, breads, fruits, and potato based meals.
    • In addition, excess salt should be avoided. Too much salt will cause the dehydration of your body’s tissues. Look for food and meals labeled with low salt or no salt added at the supermarket.
    • Physical endurance and conditioning may appear to be a good idea before mountain climbing. However, studies have shown there is no evidence that physical fitness protects against altitude sickness. [10] [11]

    Part Two of Two:
    Recognizing the Symptoms Edit

    Learn the different types. There are 3 types of syndromes that comprise altitude sickness: acute mountain sickness, high altitude cerebral edema (HACE), and altitude pulmonary edema (HAPE).

    • Acute mountain sickness is due to reduced air pressure and oxygen.
    • High altitude cerebral edema (HACE) is a severe progression of acute mountain sickness caused by brain swelling and the leaking of dilated brain vessels.
    • High altitude pulmonary edema (HAPE) can occur with HACE, on its own after acute mountain sickness, or develop one to four days after traveling above 8,000 ft. This is caused by swelling in the lungs due to fluid leakage into the lungs caused by high pressure and constriction of blood vessels in the lungs. [12]

    Recognize acute mountain sickness. Acute mountain sickness is a relatively common disease in certain parts of the world. It affects 25% of travelers over 8,000 ft in Colorado, 50% percent of travelers in the Himalayas, and 85 % of those in the Mount Everest region. There are many symptoms of acute mountain sickness.

    • These include a headache within two to 12 hours of new altitude, trouble falling or staying asleep, dizziness, tiredness, lightheadedness, increased heart rate, shortness of breath during movement, and nausea or vomiting. [13]

    Notice high altitude cerebral edema (HACE). Since HACE is a severe extension of acute mountain sickness, you will start with those symptoms first. As the condition escalates, you will contract other symptoms. These include ataxia, which is the inability to walk straight, or the tendency to wobble when walking or walking diagonally. You may also suffer from an altered mental state, which can manifest as drowsiness, confusion, and changes in your speech. memory, mobility, thoughts, and attention span.

    • You may also lose consciousness or go into a coma.
    • Unlike acute mountain sickness, HACE is rather rare. It only affects from .1% to 4% of people. [14]

    Watch out for high altitude pulmonary edema (HAPE). Since this can be an escalation of HACE, you may experience the symptoms of acute mountain sickness and HACE as well. Since it can come up on its own, however, you should watch out for the symptoms as a standalone condition. You may experience dyspnea, which a shortness of breath at rest. You also may feel chest tightness and pain, wheezing breath on the exhalation from your lungs, increased breathing and heart rate, weakness, and coughing.

    • You may also notice a physical change as well, such as cyanosis, which is a condition where your mouth and fingers turn darker or bluish in color.
    • Like with HACE, HAPE is relatively rare, with incidences from .1% to 4%. [15]

    Deal with symptoms. Even if you try to prevent altitude sickness, it may still happen. If this is the case, you should be careful not to make it worse. If you have acute mountain sickness, wait up to 12 hours for symptom improvement. Try also to descend immediately at least down 1,000 feet if symptoms do not improve in 12 hours or sooner if your symptoms are severe. If you are unable to descend, treatment with oxygen should help your symptoms within a few hours if it is available. At this point, reassess symptoms for improvement.

    • If you are dealing with signs or symptoms of HACE or HAPE, descend immediately with as little exertion as possible so as not to aggravate the symptoms. You should then reassess symptoms for improvement periodically.
    • If descent is not possible because of weather conditions or other reasons, administer oxygen to increase oxygen pressure. Place the mask on yourself and the tube of the mask in the tank nozzle. Release the oxygen. You can also be placed in a portable hyperbaric chamber. If these are available, then descent may not be needed if the symptoms are not severe and you respond to treatment. These are lightweight machines usually carried by rescue teams or at rescue stations. If radio or phone is available, report incidences to the rescue team and give them your location and wait for arrival. [16]

    Take emergency drugs. There are some medications that may be given to you on an emergency basis by your doctor. For acute mountain sickness treatment, you may be given acetazolamide or dexamethasone. For HACE treatment, you may be given dexamethasone. Take pills immediately and swallow with water.

    • Your doctor may also prescribe you emergency drugs in case of HAPE, which are non-FDA approved drugs for prophylaxis and HAPE treatment. Small studies have shown some drugs reduce the incidence of HAPE if taken 24 hours before your trip. These include nifedipine (Procardia), salmeterol (Serevent), phosphodiesterase-5 inhibitors (tadalafil, Cialis), and sildenafil (Viagra). [17]

    Descend if your symptoms are increasing or not going away while resting.

    If you have certain ailments, you may experience worsening of your condition at high altitudes. You may also need a pre-trip workup by your healthcare provider to assure safety. These include arrhythmias, severe chronic obstructive pulmonary disease (COPD), severe congestive heart failure, coronary artery disease, hypertension, pulmonary hypertension, diabetes, and sickle cell disease. You are also at risk of getting sick if you are on narcotic pain medications, which cause the respiration rate to go down.

    Pregnant women should not sleep at altitudes higher than 12,000 feet.

    Related wikiHows Edit

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    Viagra Improves High Altitude Exercise Performance Up To 45% For Some

    Date: June 24, 2006 Source: American Physiological Society Summary: Sildenafil (Viagra) significantly improved the cardiovascular and exercise performance measures of trained cyclists at high altitude, mostly because the drug helped some participants improve a lot while others showed little change. The responders improved 39% in the time trial performance at altitude compared to their performance at altitude with a placebo. Some in the responder group improved as much as 45%. Sildenafil provided no benefit to either responders or non-responders at sea level. Share:

    Sildenafil (Viagra) significantly improved the cardiovascular and exercise performance measures of trained cyclists at high altitude, mostly because the drug helped some participants improve a lot — up to 45% — while others showed little change. Sildenafil provided no benefit at sea level.

    Ten cyclists who took sildenafil at altitude collectively lowered the time it took to cover six kilometers by 15% compared to placebo trials at altitude. The cyclists also significantly improved stroke volume (the volume of blood moved out of one ventricle of the heart per beat) and cardiac output (stroke volume times heart rate) compared to the placebo trial. Sildenafil also minimized the decline of arterial oxygen saturation of the arteries when the cyclists were at simulated altitude of 12,700 feet.

    But the researchers discovered that these improvements occurred largely because some people achieve major gains with sildenafil at altitude while others improve much less or not at all. The responders improved 39% in the time trial performance at altitude compared to their performance at altitude with a placebo. Some in the responder group improved as much as 45%, according to a study in the Journal of Applied Physiology published by The American Physiological Society. Non-responders improved an insignificant 1%.

    The study, “Sildenafil improves cardiac output and exercise performance during acute hypoxia but not normoxia,” by Andrew R. Hsu, Kimberly E. Barnholt, and Nicolas K. Grundmann, Veterans Affairs Palo Alto Health Care System; Joseph H. Lin and Stewart W. McCallum, Stanford University Medical Center; and Anne L. Friedlander, Veterans Affairs Palo Alto Health Care System and Stanford University appears in the June issue of the Journal of Applied Physiology.

    Drug expands the blood vessels
    Sildenafil citrate is best known as Viagra, a drug used to treat erectile dysfunction. The drug was originally developed to relieve high blood pressure. It causes blood vessels in certain tissues, such as the lungs, to relax. This improves blood flow from the heart and increases oxygen transport to working muscles. Because the high altitude atmosphere contains less oxygen, it is more difficult to get enough oxygen to support strenuous physical activity than it is at sea level.

    Sildenafil works by inhibiting phosphodiestrase-5, an enzyme which degrades cyclic guanosine monophosphate (cGMP) a cell messenger that causes the blood vessels to relax, Friedlander explained. By inhibiting the enzyme, the drug allows greater vasodilation and greater blood flow. Although the drug works in different target sites, this study focused on the lungs.

    The researchers hypothesized that the drug would allow the study’s participants to improve their performance at altitude because it would reduce the constriction of vessels in the lungs that sometimes occurs at altitude. In turn, that would allow greater blood flow through the heart, better transfer of oxygen from the lungs to the blood and improved oxygen delivery to working muscles.

    The participants, all trained cyclists, performed a total of 10 cycling trials, with and without sildenafil at sea level and at simulated altitude of 3,874 meters. Neither the participants nor the researchers knew whether the trial included a placebo or one of the two sildenafil doses, 50 mg or 100 mg.

    The high altitude simulation was achieved by changing the mix of air. The cyclists began breathing the high altitude mix starting one hour before the exercise session and continuing through the session. The simulation did not include the lower air pressure that would occur at altitude, Friedlander said.

    Researchers analyzed the changes in each individual’s performance under various exercise conditions and also compared the group’s performance under different drug conditions.

    Responders versus non-responders
    Four of the 10 participants responded to sildenafil while the remaining six did not, Friedlander said. The responders showed the greatest drops in stroke volume, cardiac output, and cycling performance between the sea level and high altitude trials without the drug.

    “Without sildenafil, their performance went down more than others,” Friedlander said. “With it, it brought them back up to the levels of the non-responders.” The results suggest that the responders experienced a greater degree of constriction of the vessels in the lungs at altitude and therefore benefited more from the vessel relaxation effects of sildenafil.

    “One of the messages of the paper is that not everybody benefits,” Friedlander said. Sildenafil could be considered as a treatment for those who suffer most at altitude but, because of side effects that can include severe headaches and the apparent inability to help some people, it should not be taken as an exercise aid by everyone, she said.

    The bigger picture

    This study adds to the scientific knowledge of what physiological factors limit performance at altitude, including the role that cardiac output plays, Friedlander said. For instance, physiologists don’t know why some people have trouble at altitude and may develop illnesses such as acute mountain sickness or high altitude pulmonary edema while others adapt quickly. Studies like this may help identify some of the underlying differences between people and lead to better treatments.

    In future studies, Friedlander wants to identify:

    • what steps individuals could take to acclimatize before they go to altitude
    • who is likely to acclimatize quickly at altitude and who may need additional help
    • how to minimize performance declines at altitude

    Friedlander and her team are working on issues that could apply to those who have to rapidly acclimatize to high altitude. For instance, when soldiers deploy to Afghanistan, they must quickly undertake physically taxing work at 12,000-14,000 feet, conditions that can severely affect performance under potentially life-threatening conditions.

    In a study Friedlander and colleagues conducted at 14,000 feet on Pike’s Peak, Colorado, participants showed marked hormonal changes at altitude. These changes facilitate oxygen delivery. However, this benefit is suppressed when individuals don’t eat enough and the body shifts focus to store more energy, Friedlander explained. That study appears in the June issue of the American Journal of Physiology-Endocrinology and Metabolism, also published by APS.

    One next step is to do a study with women, to see if they react the same way to sildenafil and altitude. The researchers also want to take a closer look at sildenafil responders to see if they can identify ahead of time who will benefit from treatment. In addition, a question still outstanding is whether non-responders would benefit from sildenafil at a higher elevation.

    “Sildenafil improves cardiac output and exercise performance during acute hypoxia, but not normoxia,” by Andrew R. Hsu, Kimberly E. Barnholt and Nicolas K. Grundmann, Exercise Physiology Laboratory, Clinical Studies Unit, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA; Joseph H. Lin, Department of Medicine, Pulmonary and Critical Care, Stanford University School of Medicine; Stewart W. McCallum, Department of Urology, Stanford Medical Center; and Anne L. Friedlander, Exercise Physiology Laboratory, Clinical Studies Unit and Geriatric Research, Education and Clinical Center, Veterans Affairs Palo Alto Health Care System. The study will appear in the June issue of Journal of Applied Physiology published by The American Physiological Society.

    Materials provided by American Physiological Society . Note: Content may be edited for style and length.

    May 3, 2016 — Simple heat-based exercise can be just as effective as low-oxygen training to improve physical performance and altitude tolerance, new study reveals. The new work suggests that heat-based exercise. read more

    Apr. 3, 2014 — A number of studies focus on the optimal time to begin altitude training before competition, but few address the best time to come down from altitude and how long athletes should wait to. read more

    Dec. 12, 2013 — In a new study, researchers found that living between 2,000 and 2,500 meters above sea level offered the best performance enhancement compared to living at higher or lower elevations. These findings. read more

    May 8, 2012 — Sildenafil, also known as the erectile dysfunction drug Viagra, may give a boost to underdeveloped hearts in children and young adults with congenital heart. read more

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    Viagra (sildenafil) facts

    What is Viagra?

    Viagra is the trade name for a drug called Sildenafil. Viagra is one of a class of drugs known as PDE-5 (Phosphodiesterase type 5) inhibitors.

    Viagra and the other PDE-5 inhibitors can help men with erectile dysfunction (male impotence) by enhancing the erectile response when a man is sexually stimulated. Aside from Viagra, the other drugs in this class are Cialis (Tadalafil) and Levitra (Vardenafil).

    How does Viagra work?

    Viagra does not cause a man to be sexually aroused. Viagra is only effective if you are sexually aroused. To understand how it works you need to understand the mechanics of how a man gets an erection. When you get sexually stimulated, the nervous system in the erectile tissue of your penis releases nitric oxide (NO).

    The nitric oxide stimulates an enzyme that produces something called a messenger cyclic guanosine monophosphate (cGMP). The cGMP relaxes the smooth muscle cells. One result of this is that the arteries in your penis dilate and the blood can flow into your penis more easily. Another result is that the erectile tissue itself fills with blood. Both of these process result in an erection. Viagra works by maintaining the level of cGMP in the smooth muscle cells.

    If you are not turned on, your brain will not stimulate the release of any nitric oxide and you will not produce any cGMP.

    Is Viagra effective?

    Clinical studies have shown that when compared to placebo, Viagra and the other drugs in the same class, result in significant improvement in erectile function. Although established to be a safe and effective drug, Viagra isn’t appropriate for everyone and may not work in all cases.

    How does it affect blood pressure?

    Viagra can slightly lower blood pressure. This is not a problem for most men. But Viagra’s effect on blood pressure is exaggerated if the Viagra is taken with a nitrate drug.

    Nitrates are one of the treatments doctors prescribe for angina. If you take Viagra when you are also taking nitrates, the combined effect of the Viagra and the nitrates can lower your blood pressure to such an extent that it could prove fatal. Never take Viagra at the same time as taking nitrates.

    If I have a heart condition can I take it?

    If you have a heart condition it is important that you discuss this with the doctor before taking Viagra. Viagra may not be appropriate because of the danger of interacting with the nitrates.

    Can women take it?

    Viagra is not currently licensed for use by women.

    How quickly does it work?

    On average, Viagra becomes effective in just under an hour when you take a tablet on an empty stomach. Viagra can remain effective for between four and six hours. If you take it after a meal that has a high fat content, it may take longer than an hour to become effective.

    Why are there different doses?

    Viagra is available in three dosages: 25mg, 50mg and 100mg. Some men may respond to a lower dose of Viagra. Some men may already be taking medicines that interact with Viagra and thus need to adjust the Viagra dosage they are taking.

    What dose is right for me?

    The doctor needs to decide which dosage of Viagra is most appropriate. The doctor will take into account potential drug interactions, your age, the severity of your erectile dysfunction and any previous experience you have had with Viagra.

    What if it does not work the first time I use it?

    Viagra might not work the first time you take it. Most doctors advise taking Viagra at least eight times before trying a different medicine.

    What are the side-effects?

    Viagra’s Side effects are generally mild and brief. Viagra’s most common side-effects are headache and facial flushing. Less frequently, men taking Viagra have reported indigestion, a stuffy nose and a blue tint to the vision.

    Does it interact with other medicines?

    Viagra interacts with many drugs. The following list is not complete but it is important to inform the doctor of all prescription and non-prescription medication taken, especially:

    • nitrate medications (e.g. glyceryl trinitrate (GTN), nitroglycerin, isosorbide mononitrate or dinitrate)
    • nitroprusside
    • cimetidine
    • erythromycin
    • azole antifungals (e.g. itraconazole, ketoconazole)
    • mibefradil
    • rifamycins (e.g. rifampicin)
    • Alpha blockers, prescribed for prostate disease or high blood pressure
    • Ritonavir, Amyl, Butyl or Isopropyl nitrates (‘Poppers’)

    Who shouldn’t use it?

    Men who have any of the following conditions should also avoid taking it:

    • severe heart or liver problems
    • recent stroke or heart attack
    • low blood pressure
    • certain rare inherited eye diseases

    Does it treat the underlying causes of impotence?

    Viagra will resolve the underlying cause of erectile dysfunction although if the cause is primarily psychological, it may help to break the cycle of anxiety and failure associated with being unable to achieve a satisfactory erection.

    What kind of tests might highlight the underlying causes of male impotence?

    A blood test for diabetes should be performed along with cholesterol and triglyceride blood tests. It is becoming increasingly accepted among doctors that sex hormone levels (Testosterone) should also be checked by way of a blood test.

    What other impotence treatments are available?

    The other drugs, Levitra and Cialis work in similar ways. Viagra is generally prescribed as the first line treatment. Cialis has a much longer half-life than Viagra and Levitra and therefore its effect lasts much longer.

    This does not mean one has prolonged erections but the length of time available for further erections is increased without the need to take further doses. It also means however that the side effects if present will last longer. Levitra, like Cialis, can be taken with food whereas Viagra should be taken on an empty stomach.

    Some studies have shown Levitra to be more suitable for men suffering from diabetes. Other treatments include Caverject (‘Alprostadil’), which is a medication injected directly into the penis and MUSE (another form of ‘Alprostadil’), which is a pellet inserted into the urethra. These may be of use for men who have to take Nitrates and are therefore unable to take the PDE5 inhibitors.

    The use of vacuum pumps and other mechanical devices for producing and maintaining erections are alternatives to taking medication.

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    Erectile Dysfunction Health Center

    WebMD archives content after 2 years to ensure our readers can easily find the most timely content.

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    April 10, 2000 (Mill Valley, Calif.) — In his early 40s, Ron Hanson was too young to be having trouble getting and sustaining erections. But like many men, he was too embarrassed at first to talk about the problem. Hanson (not his real name) waited seven years to see a urologist. By the time he spoke up, erectile dysfunction had become a household word, thanks to the popularity of the drug Viagra. But the widely touted drug, Hanson soon learned, doesn’t work for everyone.

    When Viagra (sildenafil) hit the market in 1998, some men thought it was the long-awaited answer to their problems. Many rushed to doctor’s offices to give it a try. According to the Grey Clinic in Indianapolis, which specializes in erectile dysfunction. 17% of men between 18 and 55 experience occasional impotence, while 6% have regular erectile difficulties. For men over 55, that number jumps to about one in three. Some common causes of impotence are diabetes. heart disease. and psychological problems. It also frequently occurs after prostate cancer surgery.

    Because Viagra works in a way that’s similar to drugs that contain nitrates, however, it isn’t recommended for men who take nitrates for heart disease or those with certain other heart conditions. In some men, it causes bad headaches. In others, it just plain doesn’t work. In some instances, men may notice they have trouble telling blue and green colors apart when they start taking the drug.

    During an erection, blood flows quickly into the penis. which increases its length, width, and firmness. If the “in” vessels (arteries ) are too narrow or if blood drains too quickly through the “out” vessels (veins), men may have trouble achieving or maintaining an erection, says Arnold Aigen, MD, a urologist with Camino Medical Group in Sunnyvale, Calif. Viagra, which increases inflow, may not be strong enough to work its magic if the arteries are too narrow.

    Hanson tried Viagra, but he couldn’t tolerate the headaches it caused. Luckily, when Viagra fails, he discovered, there are several alternatives.

    Alprostadil to the Rescue

    A drug called Alprostadil. either alone or sometimes in conjunction with others such as papaverine and/or phentolamine, can be injected directly into the penis to dilate the arteries, experts say. The drug produces an erection in about 10 minutes that can last up to an hour. But there are several disadvantages, says Teresa Beam, MD, a urologist with the Grey Clinic. Some patients are averse to using a needle, which is why many men abandon the therapy. Those who give it a try may experience pain at the injection site or priapism (a painful erection lasting too long).

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    Common use

    The main component of Viagra is Sildenafil Citrate.
    Sildenafil Citrate affects the response to sexual stimulation. It acts by enhancing smooth muscle relaxation using nitric oxide, a chemical that is normally released in response to sexual stimulation. This smooth muscle relaxation allows increased blood flow into certain areas of the penis, which leads to an erection.
    Sildenafil Citrate is applied for the treatment of erectile dysfunction (impotence) in men and pulmonary arterial hypertension.
    Sildenafil Citrate may also be used for other purposes not listed above.

    Dosage and direction

    Usually the recommended dose is 50 mg. It is taken approximately 0,5-1 hour before sexual activity. Do not take Viagra more then once a day.
    A high fat meal may delay the time of the effect of this drug.
    Try not to eat grapefruit or drink grapefruit juice while you are being treated with Sildenafil Citrate .


    Before you start taking Sildenafil Citrate. tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.
    Aged people may be more sensitive to the side effects of the drug.

    Viagra is contraindicated in patients who take another medicine to treat impotence or using a nitrate drug for chest pain or heart problems.
    This medicine should not be taken by women and children as well as in patients with a known hypersensitivity to any component of the tablet.

    Possible side effect

    The most common side effects are headache, flushing, heartburn, stomach upset, nasal stuffiness, lightheadedness, dizziness or diarrhea.
    A serious allergic reaction to this drug is very rare, but seek immediate medical help if it occurs.
    Many people who use this medicine do not have serious side effects.
    In case you notice any side effects not listed above, contact your doctor or pharmacist.

    Drug interaction

    This drug should not be used with nitrates and recreational drugs called “poppers” containing amyl or butyl nitrite; alpha-blocker medications; other medications for impotence; high blood pressure medicines, etc.
    Consult your doctor or pharmacist for more details.

    Missed dose

    Viagra is used as needed, so you are unlikely to be on a dosing schedule.


    If you think you have used too much of this medicine seek emergency medical attention right away. The symptoms of overdose usually include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.


    Store your medicines at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store the drugs in the bathroom. Keep all drugs away from reach of children and pets.


    We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

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    I take 25mg on an empty stomach with a tall glass of water at 8:00AM. It takes effect in 15 minutes on the average and out love-making session goes for over an hour every time. – Age 65, Florida

    I decided to try a 25mg Viagra pill. I could feel my penis get erect within 15 minutes, getting harder than usual and lasting longer too – YT, Age 45, Nigeria

    A full 100 mg. will give you a Ginsu carving knife that, if put to ultimate use, will render her suitable for burial in a Y-shaped coffin. For most of us, 50 mg. is plenty, ensuring that you can return to a deflated state between orgasms, if so desired. But you may have to picture your grandmother naked, to do so.

    The effects last 3 or 4 hours, and it takes 30 to 45 minutes to kick in. 25 or 50 mg tabs work the same for me, no difference. Go for it. – Art, Age 62, Texas

    I bought a pill cutter at the grocery store and cut a 50 mg pill in half. It worked faster than a 1/2 hour and I had the first complete sexual experience in over 6 YEARS! William, Age 42, Texas

    25mg is best for me and I have found that Viagra makes me a super stud and the girl rides me and always has an orgasm or two. – Pablo, 42, Texas

    I find that 25 mg two hours prior to sex is best for me, and allows sensitivity, to remain at its peak. When trying 50 or 100,mg, it took away much of the feeling, and you need stimulation to maintain erection. More is definitely not better, in my case. – Phil, Age 60, California

    25mg begins to work in about 15 minutes to a half an hour and lasts for 3 hours or so, Able to have an erection and intercourse more than once in a few hours. – Age 65, New York City

    My doctor prescribed 50 mg Viagra. Wow. Instant hard on that lasts for a long time. I take 50 mg about three times a week.

    I have tried 100mg from time to time but actually seem to do better with the smaller doses. – JR, Age 65

    You have to experiment with the dosage and time lag. I started with 50 mg (good to rev my engine, I think) but ultimately found that 25 mg about 90 minutes before sex is ideal for me. Lower dosage means less nasal congestion and more feeling during sex. But 25 mg still leaves me rock hard and able to hold off climaxing just about as long as I want.

    I have experimented with dosage and now find that 25 mg about one half hour before sex is perfect for me. I’m rock hard and can go forever.

    I have the pharmacist split a 100 mg pill in four for me so I take 25 mg at a time. When I want to go all night I take the full 100 mg.

    I cut a 50 mg in half and find that to be enough.

    We came at the same time, and boy did I cum. What force! What makes this whole experience ever better is that I only used half of a 50 mg pill.

    I started off with 25 mg, and have reduced it down to 12.5 mg (roughly – I split the 100 mg pill to 8) and find that with this reduced dose, I can still have a rock hard erection as well as a greatly reduced headache.

    I have since realized I only need 25mg to keep and maintain an erection. But originally, that night, I took 50mg. – Bill, Chicago, Age 42




    Sildenafil is used to treat male sexual function problems (impotence or erectile dysfunction -ED). In combination with sexual stimulation, sildenafil works by increasing blood flow to the penis to help a man get and keep an erection.

    OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

    Sildenafil is also available in other brands and strengths for treating high blood pressure in the lungs (pulmonary hypertension ). Do not take this medication with any other product that contains sildenafil or other similar medications for erectile dysfunction -ED or pulmonary hypertension (such as tadalafil, vardenafil).

    How to use Viagra

    Read the Patient Information Leaflet provided by your pharmacist before you start taking sildenafil and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

    To treat erectile dysfunction -ED, take this drug by mouth as directed by your doctor, usually as needed. Take sildenafil at least 30 minutes, but no more than 4 hours, before sexual activity (1 hour before is the most effective). Do not take more than once daily.

    A high-fat meal may delay how quickly the drug begins to work.

    The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

    Tell your doctor if your condition does not improve.

    Side Effects

    Dizziness. headache. flushing, or stomach upset may occur. Vision changes such as increased sensitivity to light, blurred vision. or trouble telling blue and green colors apart may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

    To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

    Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

    Sexual activity may put extra strain on your heart. especially if you have heart problems. If you have heart problems and experience any of these serious side effects while having sex. stop and get medical help right away: severe dizziness, fainting. chest/jaw/left arm pain, nausea .

    Rarely, sudden decreased vision. including permanent blindness, in one or both eyes (NAION) may occur. If this serious problem occurs, stop taking sildenafil and get medical help right away. You have a slightly greater chance of developing NAION if you have heart disease. diabetes. high cholesterol. certain other eye problems (“crowded disk”), high blood pressure. if you are over 50, or if you smoke.

    Rarely, a sudden decrease or loss of hearing, sometimes with ringing in the ears and dizziness, may occur. Stop taking sildenafil and get medical help right away if these effects occur.

    In the rare event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and get medical help right away, or permanent problems could occur.

    A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction. including: rash. itching /swelling (especially of the face/tongue /throat), severe dizziness, trouble breathing .

    This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

    Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at

    In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.


    Before taking sildenafil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

    Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart problems (such as heart attack or life-threatening irregular heartbeat in the past 6 months, chest pain/angina, heart failure), stroke in the past 6 months, kidney disease, liver disease, high or low blood pressure. a severe loss of body water (dehydration), penis conditions (such as angulation, fibrosis/scarring, Peyronie’s disease ), history of painful/prolonged erection (priapism), conditions that may increase the risk of priapism (such as sickle cell anemia. leukemia, multiple myeloma ), eye problems (such as retinitis pigmentosa. sudden decreased vision, NAION).

    This drug may make you dizzy or cause vision problems. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages.

    Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

    This brand of the drug is usually not used in women. During pregnancy, sildenafil should be used only when clearly needed. Discuss the risks and benefits with your doctor.

    It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.


    Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

    A product that may interact with this drug is: riociguat.

    Sildenafil can cause a serious drop in your blood pressure when used with nitrates. A serious drop in blood pressure can lead to dizziness, fainting, and rarely heart attack or stroke. Do not use sildenafil with any of the following: certain drugs used to treat chest pain/angina (nitrates such as nitroglycerin, isosorbide), recreational drugs called “poppers” containing amyl nitrate, amyl nitrite, or butyl nitrite.

    If you are also taking an alpha blocker medication (such as doxazosin, tamsulosin) to treat an enlarged prostate/BPH or high blood pressure, your blood pressure may get too low which can lead to dizziness or fainting. Your doctor may start treatment with a lower dose of sildenafil to minimize your risk of low blood pressure.

    Other medications can affect the removal of sildenafil from your body, which may affect how sildenafil works. Examples include azole antifungals (such as itraconazole, ketoconazole), macrolide antibiotics (such as clarithromycin, erythromycin), HIV protease inhibitors (such as ritonavir, saquinavir), hepatitis C virus protease inhibitors (such as boceprevir, telaprevir), mifepristone, rifampin, among others.

    Do not take this medication with any other product that contains sildenafil or other similar medications for erectile dysfunction-ED or pulmonary hypertension (such as tadalafil, vardenafil).


    If overdose is suspected, contact a poison control center or emergency room right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include severe dizziness, fainting, painful/prolonged erection.


    Do not share this medication with others.

    Missed Dose


    Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

    Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

    Information last revised October 2015. Copyright(c) 2015 First Databank, Inc.


    Viagra dosage recommended


    Viagra is a blue diamond shape and levitra is round and yellow, both are similar and the effects of the erection tablets last on average four hours, though some studies suggest some benefit for up to 10 hours. It is recommended that those prescribed Viagra or Levitra take it half an hour to an hour before sexual activity. Viagra comes in 25mg, 50mg, and 100mg tablets, with most men starting on the 50mg pill and changing doseage if necessary. Levitra comes in 2.

    I hav used Tri Mix # 4 and i can’t get erect to almost 3/4 ercetion and I have trouble keeping it in.

    Also I am on a very low dosage (25mg per day), would increasing my dosage (under doctors supervision) recommended to prevent future SVT episodes? Given my age, is ablation as safe for me as other younger people with this problem. Since I my episodes were 20 months apart, what do you feel is the best approach. I travel quite a bit with my family and I am just crazy with fear that I will have an episode while flying.

    Thank you for your feedback. It was never "cultured." The first time I was in the military and the doctor had all the corpman look at me because it was a "classic example" of shingles that followed a nerve from centerling front almost to the spine. The second occurance I was living in China and it was "obvious" what it was based on my first experience and the area affected mirrored several photos i found online.

    Saw Urologist 3-4 years ago who diagnosed a flaccid Nuerogenic Bladder. Urologist recommended he shave all hair from shaft & sack continuously and also said by inserting a Prostate anal probe during intercourse to help reach ejaculation more easily. He tried 6-7 times but can not get over homophobic feeling. There was not much difference either way but he does say has more sensation with hair removed. We are willing to try just about anything. Have heard of surgery to correct ED problems?

    They make absolutely no sense. They pay for viagra. but they won’t pay for birth control pills. They won’t cover fetal reduction, but will have to fork out enormous amounts of cash when some poor woman gives birth to 4 or 5 babies and they are hospitalized. *grumble* Ok, I’m off my soapbox now.

    In my opinion, I think we should be discussing reduction in dosage. not stopping. But I have had this sort of issue with my dr. in the past. What do you guys think?

    . you take the heart drug and it affects your libido, so they give you Viagra. But Viagra upsets your stomach and they give you Nexium. But Nexium makes you gain weight and your blood pressure climbs and they start in on the Cartia, but all of this stuff causes depression and lethargy, so they start you in the psychotropic meds. WHO DO THESE PEOPLE THINK THEY ARE, GIVING US A DOZEN MEDICATIONS. They certainly aren’t healing anybody.

    Well if it worked this good for me, maybe there is some one else out there it can work for, perhaps with my recommended method, frequency and strength it will work for others. The results are dramatic! From Jan 09 to Mar 09 to go from over 10 Million down to 300 thousand viral load. What more proof do you need with a 97% reduction in VL? If there is a possibility that something may work, but did not, I never felt like it was a waste even if I paid a lot of money for it. I am not rich at all!

    I posted the websites i am currently looking at on the other forum. I want to loose about 15 lbs and i dont know the recommended dosage for how much i want to loose. i heard you’re siposed to take it for 2 weeks the 2 weeks off? & if i stop taking it i will gain everything back right? Do you know how this all works? Thankx!

    Medicine my dog is on daily Vetmedin 5mg twice a day–(basically helps blood flow without overworking the heart—prior to this newer medicine vets did not have a lot of good heart meds and some prescribed Viagra –although VetMedin is expensive, Viagra is more expensive!) This bottle contains 50 pills so it lasts almost a month and costs me $85, my mom’s vet charges $75 for it, so it varies a bit.

    most recent tsh is close to a 4 I am currently on levothyroxine 25mcg, which is a baby dose. my hypo symptoms made a comeback, symptoms come & go, but not at the level they were before treatment when I was over 11 several months ago, at that number I actually thought i was dying! So someone hellp me out here.

    Hi. I’m confused and lightheaded and will try to make this concise, thank you! On 5/14 my A.M. and P.M. serum cortisol both came up at 0.5mcg/dl. My GP started me on hydrocortisone while I waited to see an endocrinologist. GP said straight up that he has no idea how to treat adrenal stuff or dose hydrocortisone.

    I lost my left tube with the ectopic so the doctor strongly recommended moving on to IVF. Do you know when you will be starting your cycle.

    I also feel it is a crime that in this day and age and there is no help for this damn menopause. Yet they invent Viagra for men so they can find a younger women because wifey sure is not in the mood. A site like this helps knowing you are not alone. Woman are looking for help. So its hard when someone tells you it is your fault because you don’t exercise enough or your not eating right. Maybe things are working for you, but it isn’t for me and it sure isn’t for Wellness Seeker.

    I guess I’ll have to take the alpha blockers or Viagra beforehand. Doctors don’t have a clue about this. I have asked several Urologists, and they just say it’s normal.

    My GP didn’t understand lacking sensation/feeling libido and said this was all in my head and would only do basic tests because I insisted. Taking viagra although this may help in the short-term is just papering over the cracks of what is really going on here. All blood tests I had came back "normal" but that doesn’t mean it is normal for "you" For instance my TSH was 2.

    it could be a medication he is taking and just a matter of changing it. There is Viagra and Cialis to help and for the most stubborn mind an injection which makes the little guy stand to attention no matter what. IF it is in the mind, its a tiny little needle they would not feel it. Ladies this takes a lot of tact and gentle care. imagine them as poor little souls that have.

    Without really thinking much about it, I started using tramadol every day and then increased this to 2-3 times each day. The dosage was 100mg, so I was taking 100-300mg daily (or 2-6, 50mg pills) for 3 months. After I finished the project in mid-may, I decided that I needed to stop using a drug to get through the day, so I tried to just stop taking it. WOW!

    In that break I started acupuncture and a bunch of extra stuff she recommended (always eating hot foods, lots of meat which is hard cuz i hardly ever used to eat meat, drinking iron floradix, taking calcium, and drinking some rejeuvalax every day, oh and drinking tons of herbal water with honey). I also finally got serious about getting to bed by 10, and found this meditation series on Circle and Bloom that’s specifically for IUI/IVF.

    I used Monistat 7 though which I guess isn’t as bad of a dosage or something I’m not sure but either way just seconds after I inserted the cream. horrible burning pain to the point of tears and where I felt like I was going to pass out! It was insane. I thought maybe something was wrong with me. I am glad to read that I am not the only one with this problem and that maybe this is normal. I think I will take a trip to the doc to get my yeast infection fixed.

    I am scheduled to see a urologist in 3 weeks and am trying to stay optimist. I tried Viagra and it helped some, but is way too expensive to take everyday. Not to mention that I think it is a little ridiculous for a healthy 21 year old to have to take it to have a functional penis. I am physically fit and exercise daily (have to in order to keep from getting anymore depressed about it). I have no idea what has caused this problem, but it needs to be fixed.

    I had a similar situation; Erectile dysfunction set in in 1997. Viagra helped when it came on the market. Retrogressive ejaculation followed in 2001; it may be as a result of damage done during removal of kidney-stone although doctors seem to disagree on this. Found blood when masturbating (but none in urine) earlier this year. Saw doctor and had pta test done. It was normal. I went though hell while waiting on result. I was almost sure I has cancer. The condition cleared up.

    Please tell me if I am allowing too much or not enough time in the spacing/reduction of dosage and how many days I will be unable to function during the stop in June-if gameplan works, I will have tapered to half a pill by then. I have two teenagers, and I am very much Mom’s taxi service, so I will need to make arrangements for them if I am too ill to drive.

    I agree – I have recommended the use of the mirena to so many people and they all love it.I also got pregnant very soon after having it removed, so no long term recovery. I honestly thought it was fantastic, very comfortable, no periods, no worry of pregnancy and no effects from the hormones that I am allergic to. If the mirena does cause cysts I can’t understand why they would give it to my sister who has been suffering for so long due to polycystic overies.

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    The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.

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    Consecuencias del viagra en adultos

    En el mГЎs notable de esto, protege la piel de su efecto negativo de los rayos solares, junto con permite erradicar varias enfermedades de la piel. Esto mejora la circulaciГіn de la sangre en el interior de los Гіrganos de la reproducciГіn. De cualquier manera, la nueva publicidad de Viagra sin duda se destacan revolcГЎndose en su categorГ­a. El agua del grifo a menudo contiene cloruro, fluoruro y la contaminaciГіn que podrГ­an ser tГіxicos a travГ©s del tiempo. Sin embargo, el fabricante del medicamento para la disfunciГіn erГ©ctil, Pfizer, se atienden a los hombres necesitados de este medicamento directamente de otra pГЎgina web, de acuerdo con un conjunto de Fox News, de 6 de mayo. Conseguir una buena recomendaciГіn a un amigo de confianza es a menudo la mejor manera de buscar. Dolor de cabeza, nГЎuseas, indigestiГіn y dolor muscular son sus efectos secundarios mГЎs frecuentes. Mientras que sГ­, que realmente es increГ­blemente estГєpido simplemente haga clic en un enlace de vГ­deo similar a esta, eso es parcialmente el punto. A menudo es una mirada que ahora usted puede lograr, y la pГ©rdida de cabello no es ninguna excusa para perderse. No puede haber una idea falsa sobre el sexo que el interГ©s sexual disminuye de manera constante, como nuestra edad avanza hacia el futuro, y todos aceptamos ED como un problema natural. Ordenar medicamentos en lГ­nea sigue siendo una tendencia captura rГЎpida a lo largo del globo. Buscando estrategias para compartir el DГ­a de San ValentГ­n usando su perro mascota. Con base en esta evidencia y sobre el hecho de que el SLS es usualmente absorbido en cualquier lugar con la piel, la exposiciГіn con sulfatos en champГє puede causar desarrollo anormal de los ojos en los niГ±os mГЎs pequeГ±os. Para los hombres que serГЎn mayores, la utilizaciГіn prolongada de los productos de Viagra sin duda puede conducir a una mala visiГіn o ceguera. que puede ser que aflige a miles y 1000 de los hombres en este mismo momento. Nuestra farmacia ofrece todo tipo de medicamentos y entregar en cualquier lugar, independientemente de donde usted vive dentro de este mundo. Kalwant Rana es un escritor independiente para Descubra un tratamiento natural para la fijaciГіn de la disfunciГіn erГ©ctil. asГ­ como informaciГіn Гєtil sobre el mejor pГ­ldora mejora masculina.

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    Mantenga previsto que el ejercicio puede ser acoplado con una gran dieta. sГіlo tienen problemas para mantener durante mГЎs de 15 minutos. La marca de Citrato de Sildenafil suministrado en mi experiencia fue Zenegra, hecho en la India por Alkem Laboratories Ltd, uno de los mayores fabricantes de productos farmacГ©uticos en la India, ademГЎs de una empresa que ahora estГЎn empezando fabricaciГіn dentro de los EE.UU. Pregunte a sus mГ©dicos de bienestar que se siente para tratar con hombres que pueden haber que sufren de problemas de erecciГіn. Sin embargo, la compaГ±Г­a de la medicaciГіn impotencia masculina, Pfizer, se atienden a los hombres que requieren este medicamento directamente en su pГЎgina web, de acuerdo con un conjunto de Fox News, de 6 de mayo. Se empieza con el aprendizaje de cГіmo llegar a su tono de piel adecuado. Problema sexual no sГіlo conduce a problemas fГ­sicos, sin embargo, tambiГ©n puede causar problemas psicolГіgicos y todo esto afecta a unos salud. Con estos productos le sucede que se va a poseer una erecciГіn mГЎs dura y prolongada que puede va a generar que junto con su pareja muy satisfecho. Viagra se indica a menudo para los hombres que sufren de disfunciГіn erГ©ctil o la disfunciГіn de la erecciГіn o para los hombres mayores que podrГ­an poseer algunos problemas para mantener la erecciГіn. La marca de Citrato de Sildenafil suministrado en mi experiencia fue Zenegra, hecho en la India por Alkem Laboratories Ltd, uno de los mayores fabricantes de productos farmacГ©uticos en la India, ademГЎs de una empresa que ahora estГЎn empezando fabricaciГіn dentro de los EE.UU. com, que opera desde Ginebra, Suiza, para hablar de los ahorros con sus clientes potenciales y ofrecerles exactamente los mismos marcos y lentes que a menudo se encuentran en las tiendas a un precio tres o cuatro veces superior. Bueno, la respuesta es, sin duda que sГ­, porque las tensiones sexuales personalizar toda la relaciГіn y dar lugar a diferencias entre el dos. Viagra es uno de los problemas de erecciГіn medicamentos de tratamiento mГЎs populares.

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    Ir a la entrada

    En personas mayores de 65 aГ±os, el personal mГ©dico especialmente debe evaluar clГ­nicamente el estado de salud del paciente.

    AdemГЎs, se debe efectuar controles paraclГ­nicos a fin de corroborar los niveles de salud general a la hora de recibir tratamiento para la disfunciГіn erГ©ctil .

    En la mayorГ­a de los casos, si el tratamiento para tratar la disfunciГіn erГ©ctil se efectГєa con Viagra (Sildenafil ), en los pacientes mayores de 65 aГ±os se les recomienda empezar el mismo a una dosis menor que la usual. Generalmente, 25 mg de Viagra (Sildenafil ) es la dosis recomendada en el inicio del tratamiento en estas personas.

    Es fundamental que el paciente tenga un estricto seguimiento mГ©dico a fin que se tenga una evaluaciГіn constante del tratamiento con Viagra (Sildenafil ). En tal sentido, la dosis podrГЎ ser ajustar segГєn cada caso.

    Viagra (Sildenafil): sus contraindicaciones.
    Efectos secundarios del tratamiento con Viagra (Sildenafil).
    Mecanismo de acciГіn de Sildenafil (Viagra).
    Usos del Citrato de Sildenafil (Viagra).
    Citrato de Sildenafil (Viagra): generalidades.

    2 Respuestas to “Tratamiento de la disfunciГіn erГ©ctil con Viagra (Sildenafil) en adultos mayores de 65 aГ±os”


    Estimado Alberto: Es importante que consulte con su mГ©dico al respecto. Evite los riesgos de la automedicaciГіn.

    EnvГ­a tu Respuesta

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    Cialis, Levitra, Staxyn, Stendra, and Viagra work similarly. There are subtle differences in how long the drug works and how quickly it works.

    Levitra works a little longer than Viagra. They both take effect in about 30 minutes. With Levitra, the effects last for about 5 hours. With Viagra, they last about 4 hours.

    Cialis works much longer — up to 36 hours in some cases. Stendra can start doing its thing in as little as 15 minutes, and its effects last up to 6 hours.

    Staxyn dissolves in your mouth. It contains the same active ingredient as Levitra, but it should not replace Levitra. It also can begin working in about 15 minutes.

    If One of These Doesn’t Help Me, Can I Try Another?

    Yes. But because these drugs work the same way, you’re likely to have similar results.

    What Precautions Should I Take Before Trying One of These Drugs?

    There are situations where these drugs may not be safe. Before you take them, tell your doctor:

    • If you are allergic to any drugs, including other ED medications.
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    • If you take nitroglycerin or a similar medicine for chest pain. The combination of ED medication and these drugs can cause dangerously low blood pressure .
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