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aftermath of cheating
My good friend Madeline over at https://madelineharper09.com blogged about the ending of her affair. For those of you who follow my blog, I haven't even begun to write much about mine but suffice to say, our stories have overlapped since the beginning. She has since moved on but it was difficult for me to read along, as I've been there. I empathized with her pain, as well as knew first hand the pain of being a betrayed spouse. I also understood her affair partners reluctance to engage in the relationship any further. Juggling two relationships takes more work than anyone realizes (take my word). It taxes the mental file boxes so to speak.
Grief. Confusion. Pain. Sorrow. Love. Fear.
So many emotions pulse through your veins when facing the end of an affair. I haven't divulged about my affair, but I wanted to share an actual email which I sent to CEO at the end. It mirrors so much of Madeline's pain. Our lovers may be different, but I get where Madeline was at. I understand how it feels breathing through a vice-grip day in and day out, all while trying to function for your children. As humans we strive for knowledge, to make sense of our world and the relationships within and around it. At least we should.
Esther Perel once said, "Depending on the circumstances, anyone is capable of anything. This is a crucial piece of knowledge to hold, if there is true intention, to engage empathically with our fellow human beings. It is easy to cast off those that perpetrate or endure horrific things, as being unlike us or different in some way. And my worry is if we operate from that standpoint, we will always be operating from a place of disconnection and isolation. Empathy entails putting yourself in the shoes of another. It is important that we all challenge ourselves to cultivate this ability, because given the right circumstances or right conditions, we are all capable of anything.
The importance of struggle and pain is crucial to the development of character. The process of recovery is transformational. There is a great cost to the character of human beings if things are achieved too easily."
As I followed Madeline's journey, I couldn't help but sincerely wish that her pain transformed her, just as the pain I caused transformed me. You should realize, I am in a different place than when I wrote this letter. But make no mistake, I sat in the crosshairs of gut-wrenching pain and my consequences for a long, long time. I struggled immensely, yet grew out of those ashes into a better person–a better wife–a better friend and better mother to those around me.
I came to the beach and ran all the way to the end. I wanted to feel close to you. To see your face amongst the crowds. Maybe even bump into you going for a run (we never did race!!)
My mind pondered so many things, thinking how just 1 week ago you said "I want you." And how on a dime, that suddenly changed. I still don't get it.
I ask myself constantly "Did he ever truly care for me?" You said you weren't the man I thought you were. What does that mean???
I think you did care for me but I am so confused. I reached for my tablet this morning, wanting to turn it on to see if you had written. But I had to stop myself as this habit is so ingrained in me, to include you in my day to day life.
Last night, I took Vivianne to the outdoor concert. I left my phone at home by accident. Normally, I would have sent you a message talking about date night or our plans for the weekend. And in that moment, I realised just how much your presence truly was in my life.
We may have started off as adventure seeking lovers but you became one of my closest friends over the past six months. And I adored that CEO. Simply put, losing you and your friendship hurts me the most. I have felt your support and laughter through so many months now, seeking advice, sharing my thoughts, concerns, fantasies and more.
I grew….as a person…..by knowing you CEO. That is one compliment which I've never said to anyone. Read that sentence again, slower now. Because very few people have ever come into my life and impacted me in so many ways. You are one of them–having made such an impression on my heart.
I look for the number 1 to appear in my inbox all the time. Seeing a message from "CEO" pop up gave me companionship during the chaos and monotony of my days. I noticed your name says ceo (lowercase) now in my inbox. And I wonder what you changed in your settings. I wonder if this is another step forward to disconnecting what had been our connected lives. It makes me well up in tears and I fan my face trying to breathe through the pain.
I hear footsteps behind me as I sit here watching the waves. And I wish they were yours so that I could tell you just how much I will miss you in my life. Waves of grief wash over me as if I have lost an arm or something. It hurts that much.
As I ran here today, I saw a vision of me working late at night putting together a business plan. The next picture was me at a table negotiating with a bunch of executives. Then finally another picture of me reading a news article talking about my company. I was giving an interview and they were asking "How did a mom get involved in the industry–how did you do it?" And I answered, "I met someone who inspired me to dream again. A CEO who showed me how to juggle a house of cards….I dedicate this to him."
With that picture in my mind, I burst into tears thinking that in time, you and I will be referred to in the past tense. I never want to lose your friendship and tried to ask you how our interactions would be going forward. Likely this may happen over time. But right now, I can't let go of someone whose friendship meant the most to me of all.
I care about you…always will. And CEO–you may not feel that you are a great person. But I felt it with you. And I know you are. I still believe in you. Everything with you was magical and that is how I will remember us.
I remember being in so much pain when I wrote those words. Thinking of not hearing from CEO every day ripped my heart out of my chest. Our lives had become so intertwined, both of us were a source of encouragement to the other. Whether he was having a bad day because an investor pulled out, or if I was struggling with the work I was handling–we always reached out. Losing his friendship was the death kneel, but I knew No Contact would be for life. It killed me to think I would never see his smile again. Never hear his laugh. Never share our fantasy world again.
But…over a year later, I can say that the pain diminished enough to function. It waxed and waned over those first few months but the overall trajectory was there. Two years after Dday, you are solidly looking forward and living your life, without the constant feeling of missing their presence. It may not feel that way in the beginning (the first three months of No Contact are brutal) but you do get through it. Make no mistakes, you carry the memories of them wherever you go, but they've been relegated to a filing cabinet that rarely gets unlocked. The mental pictures you had swirling around in your head for so long, become fuzzy. You don't see their face with clarity and definition any longer. It's like they become a photo or snippet of a movie, when memories pop up. And you are seeing it from afar.
I believe in order to move forward in your life, at some point you stop looking back so much. You just do-instinctually. You begin to live more in the present and little by little, you dust yourself off and rebuild your life. One day at a time.
In the beginning, it's an accomplishment to not burst into tears every time you drive or hear a song on the radio. Or maybe just being present long enough to say, "I'm good, thanks" when a grocery clerk asks how you are. A few moments suddenly becomes a few hours, and then it grows to a whole morning that you didn't think about "them". As time moves forward, eventually days fly by. And one day, maybe a whole year later, you get an entire week or two as a reprieve for your hard work. That's pretty much the first year after Dday in a nutshell, my friends.
Truthfully though, you won't ever forget your affair partner. The good memories or bad ones–they are in that memory bank for life I'm afraid. But you do heal. You do. In time.
I'm proof of it Madeline.
Well we finally arrived after two flights and a long layover in between. The kids took it in stride and even walked themselves through immigration. I feared they would be asleep and we would be carrying them ourselves, since that is when they are normally sleeping. But it worked out perfectly.
As we came out of the airport, someone was there to greet us with the car we had rented. No waiting in lines- wow, I could get use to this. As my husband placed our suitcases into the back of the car, he jammed his suitcase against him. His right hand caught a piece of metal which was at one time, part of a side carry handle. I looked at his face, then saw the blood, and he said, "I think I cut my finger down to the bone."
The woman took him to a nurse who works in the airport. We sat next to our rental car saying prayers for Daddy to be ok. And for this to please, not inhibit the fun he has looked so forward to. My heart sunk knowing all the water activities we had dreamed of doing while here. Fifteen long minutes passed when Daddy suddenly appeared saying, "It's not to the bone-just a deep cut." Phew…a huge sigh of relief came flooding out.
We drove about an hour through villages and such, till we finally reached a stone sign. As we drove down a twisting road (think Lombard Street in San Francisco meets the jungle), we suddenly broke out in the giddiest of grins.
You park your vehicle and then the resort ferries you further down the ravine in little tuk-tuks reminiscent of the ones in Thailand, only much nicer. As the driver turned the last corner, there stood our own private butler- local drinks in hand literally welcoming us to paradise.
He brought us into our room- and it was stunning. Views of these majestic mountains coupled with white plantation shutters…four poster bed covered in a white mosquito net.
I'm a visual person so this place is a feast for your eyes and for anyone who loves architecture. I still can't believe we are here…in such paradise enjoying our marriage and family after so much destruction. I feel grateful beyond words that my husband didn't give up on us, that we have finally rebuilt a solid marriage where honesty reigns (despite how difficult that has been) and that we haven't allowed our past to destroy our family.
I never thought being 2 years past Dday could feel so great…but it does. We are making new memories and CEO feels so far behind us now. This is proof that all those articles you read after Dday are true: some couples rebuild their marriages into stronger, more resilient ones. I am very grateful to say, we are one of them ❤🌴☀
Protected: Progress
When you are facing the collapse of your marriage, it's a pretty surreal moment. For me, it felt like I was standing on the side of a cliff. And here was my husband failing miserably at a variety of mundane tasks- but I couldn't save him anymore. I reached a point where I had nothing left to give. It was like I was watching a comedy of errors with regards to his behavior. But I stood firmly planted on solid ground, unable and unwilling to give him any further rope.
After I published my last post, he read it and was ashamed of his behavior. We talked that night and then the following day, things seemed eerily quiet during afternoon. We banned the children from our room and calmly talked about our relationship– from beginning to end, rehashing every major pivotal moment in between. It ended with me saying, "I deserve to have a husband that I can rely upon. I need and want a partner who will lead this family and our marriage. I can't fill every role, while you sit idly by acting like an irresponsible twelve year old. Your behavior is appalling. I don't respect you when you behave so irresponsibly. And I'm not attracted to you whatsoever when you behave like this. I no longer wish to have sex with you. I don't want to share a bed with you. I'm done."
And that was that.
He slept on the hardwood floors of our living room for three nights, until I finally said that was insane. At the very least, take the bed in our daughters room. I will move her into our bed, after she falls asleep each night. So that's what I did. She's a lot heavier these days, so this wasn't the easiest of tasks. Every morning, I awoke to her angelic face. I had forgotten just how lovely she is sleeping next to me. It made me think back upon all those naps we took together when she was an infant/toddler. And how quickly the time was passing by us. Quite honestly, I enjoyed the renewed bond I felt those evenings and her presence became the highlight of my day. She would awaken each morning, and we would get just enough time to cuddle and have girl talks before Zane crawled into bed too. It was nice and sweet, despite the undercurrent which brought her into my bed.
The following day, I had tons of work to do, so I left for the day. But when I came home, my husband was dressed in his Hugo Boss suit, as if he had a conference to attend. Only, he didn't. I must have looked at him bizarrely because he offered up right away, "Everything I have done before wasn't working. So today, I am doing everything different." Normally, he would be working in casual clothes but recently he had stayed in his pajamas, that's how lazy he had become. So finding him dressed to the nines, and sitting working on his laptop, taking conference calls–well it was just funny to see. As I began washing the piles of dishes he created that day, I couldn't help but smirk. A wave of pessimism washed over me. If putting on a Hugo Boss suit makes you feel better about your crumbling marriage (and if that somehow is going to change directions for you), knock yourself out there buddy.
But I didn't say that. I'm not that cruel…but the cynic in me certainly thought it. Call it years of hearing words but never seeing actions. It seemed as if he was grabbing at straws.
We went to bed that night, barely saying a word unless it was regarding the children. There was an obvious tension between us with minimal eye contact exchanged. The following night, he slept in the other room and truthfully, I was grateful for the distance. I needed space away from him. His presence honestly repulsed me.
On my daily run, I kept seeing For Rent signs everywhere. Considering we live at a high demand beach, you don't see many of them. It felt like a sign: that I was meant to move out. As I ran, I would dream of a little beach cottage. Just me and the kids. Even if it meant living in a tiny one bedroom, I would make it work to stay where we live. To keep the kids lives the same. Schools etc. But then the realist popped back into my head and screamed, "There is no way you could handle living in a tiny apartment, even if it was at the beach. Having neighbors resting upon neighbors- so close like cockroaches. You know that would drive you nuts. You need space. Solitude. And peace and quiet. Not the sound of bottles being smashed at 2 am every weekend by inconsiderate beach dwellers." My fantasy quickly evaporated into reality once I reached the last mile of my run.
That evening I went to bed, much the same as I had before: mentally exhausted and forlorn.
The following day, my husband seemed driven. Exuberant in his conference calls. He had a pep to his step and he was acting like a man on a mission. It was borderline annoying and somewhat delusional as I thought," Doesn't he realize our marriage is kaput?" As I made fresh grapefruit juice, he stood in the kitchen and asked, "Can I use your car this afternoon?" Before I had a chance to respond he added, "I made an appointment with a therapist. I have an appointment during my lunch hour. She's covered by our insurance and highly rated online." I'm not going to say I was impressed because after years of becoming so disillusioned, it's going to take a helluva lot more than one appointment to reverse this marriage. But I felt hopeful in that moment. And thats a huge thing friends. Because this has never happened before.
As I walked through the kitchen, I noticed it was cleaned. Dishes done. Counters wiped. Dog fed. Sticky notes were put on cabinets with reminders to buy grocery items that he used the last of. And the trash cans were taken to the curb. All of them.
I could see he was truly trying. He's always "tried" in the past too, but only for a few weeks and then it was back to the lazy habits. I recognize his efforts are certainly better than nothing. But truthfully, I wasn't holding my breathe. Real effective change is a long term result which won't be seen for a long time. I am however, quietly optimistic.
And hopeful for a redeemed marriage.
The End
When do you call it quits? At what point do you finally acknowledge- too much damage is here and we can never repair the tsunami that blew through our marriage. When? What's the formula for making that determination?
I read an article this week that said 57% of marriages stated they were thriving five years after discovering an affair. We aren't even close to being included in that group. For some reason, finding this out demoralized me. It's been five years since my husband confessed and I feel our marriage is in crisis more than ever.
Those that know me off blog understand just how dire things are. But I will peel back the curtain slightly and share just one example of what I battle. I've had plenty of discussions with my husband lately- hours worth in fact. An incident occured weeks ago, whereby he admitted he lost his drivers license and had no way to rent a car. You see, his irresponsible behavior caught up with him when he failed to take care of his vehicle resulting in blowing up the engine. Yep, that's what happens when you don't check your oil people. I could have killed him.
So here he was- without a car- and unable to even rent one. When it dawned on me…he lost his drivers license when he went CHRISTMAS shopping over three months ago. Christmas people!!! Now I don't know about you guys, but my brain would have been screaming at me to take care of my missing drivers license. Like within 2 days of realizing I lost it. Every time I drove, I would have been stressed out knowing I was driving without one. But that's just me. Clearly, my husband and I are polar opposites in that way. Me being the responsible one–him shirking away from all responsibility. Yep, he stuck his head in the sand (again).
I asked him point blank, "Are you having an affair? Your behavior reeks of someone who has checked out of their marriage. I know the signs and you are simply not "with it". He assured me he wasn't, emphatically denying it.
So I went about asking a barrage of questions, "Why have you not made an appointment with the DMV?" And he said, "Well I looked online but they didn't have one for months."
"Ok but did you try looking at different locations?"
" uhhhh…no"
With a few swipes on my phone, I found several locations with availability that week. But he needed a car ASAP, so he really needed a replacement drivers license fast. He logged onto his computer while I yelled across from the kitchen, "March 15th–I found one at XYZ city. You'll have to drive 45 minutes but they could see you in 2 days."
More groans…when finally he found an appointment for the next day, although he would have to drive an hour away (not a big deal–an inconvenience but doable). Phew, crisis averted. He is scrambling to resolve. I'm obviously frustrated by his laziness but I'm seriously sitting on the sidelines trying to allow the natural consequences of his behavior to wreck havoc on his life. Nothing motivates people more than the feeling of shit of the world mounting upon you.
The next day he left for work. I looked at the time later that afternoon and thought, "Oh he is probably leaving the office now for his DMV appointment." When all of a sudden, wouldn't you know it-he calls me in a panic. "Can you please gather up all these documents? I need them for my appointment, to get my drivers license. And can you drive them to the freeway and meet me? I won't be able to make my appointment otherwise, as I am short on time!"
I could have killed him.
"ummm… You want me to drop what I am doing to come and bring you your paperwork? Don't you think you should have read the DMV requirements for getting a replacement license last night? And retrieved those prior to leaving the house this morning? You want me to save you–to bail you out? I really think the best option is to let natural consequences fall upon you for not being prepared. For not having any foresight…"
Wish I could say I stuck to my gut response, but I didn't. Time was of the essence. Natural consequences did not fall upon him. I bailed him out, driving to where he needed me and giving him the papers.
In that moment, I realized I am just an enabler to him.
I am disgusted by his behavior. It's as if I am married to an irresponsible 12 year old. When I handed him the papers, we didn't even say a word to eachother. A few minutes later, I sent him the following text:
"I'm honestly done being married to you. I am. I would rather be a single mother and at least have a shot at happiness than keep pushing mud up a mountain. You aren't happy. I'm not happy. It's obvious you will never be what I need in a relationship and it's about time both of us face that fact and pull the plug.
If you want to be lazy that's fine. But don't drag me into the lazy husband pool anymore. I've allowed this for far too long. I've become an enabler to your shitty behaviors and you've lost me. I have always said the affairs won't be the reason why we divorce. It will be THIS dynamic which will break us.
It has.
We are done."
His reply? None…crickets.
We have since cooled down. And we've had more talks. Still living in functional harmony like we always do. Still socializing with our neighbors and doing things with the kids. Putting our best faces on. But the issue remains.
Today (on Easter nonetheless) we had a monumental 6 hour discussion spanning the entire length of our marriage–what's gone wrong, at what point/what was going on in our lives during certain parts. His perceptions. My perceptions. His hurts vs my hurts. We've gone through it all. I think the end is near for us.
So something popped into my mind this week that never has before.
The loss of CEO caused me unbearable pain friends. It's taken me so long to even write that but it did. More than he will ever truly know. But perhaps that pain was to prepare me for an even greater pain–that of losing my husband and all the unmet dreams I had for us.
I can't even say that I am holding on by a thread anymore. One person can't make a marriage. One person can't be the only one communicating. One person can't give and give and give, while the other one takes and takes and takes.
As one of my blogger friends said to me offline, "A grown man who can't handle his drivers license and car? Friend, this problem is far greater than YOU."
So when do you finally say "enough"? When do you finally pull the plug friends? I refuse to become an ugly person should we divorce. I will hold my head up high and walk away with nothing, if I have to. I don't want to fight. I want my children to be proud of me. To know and see that I didn't let my pain turn me into some bitter person. I want an amicable divorce. An unconscious uncoupling if you will. One where we are still close friends, still vacation together with our kids–but just are no longer lovers or spouses.
I just can't be the glue holding everything together anymore. I have nothing left to give. I need a true partner in a husband. My heart is screaming to have my needs met in our marriage, and it falls upon deaf ears because he has his head stuck in the sand. My husband stopped trying- stopped fighting for us. Stopped working at building a new marriage. He admitted it wholeheartedly tonight when I confronted him. So nice of him to have shared that memo with me.
I never married with the intent to ever divorce. It simply was not an option in my mind. I always believed we would work anything out, even this. But I'm spent. Emotionally I'm done. I feel an incredible desire for closure and to just be alone.


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K-doped Co-Mn-Al mixed oxide catalyst for N2O abatement from nitric acid plant waste gases: pilot plant studies
(Industrial & Engineering Chemistry Research. 2016, vol. 55, issue 26, p. 7076-7084.)
Activated carbons prepared from a broad range of residual agricultural biomasses tested for xylene abatement in the GaS phase
(ACS Sustainable Chemistry & Engineering. 2017, vol. 5, issue 3, p. 2368-2374.)

subset: commoncrawl


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Zouheir Sekkat was a Postdoctoral analyst at Max Planck working under Professor Knoll. Dengan arus listrik yang kecil maka energi yang hilang pada kawat transmisi energi disipasi juga kecil. The majority of the systems outlined in this monograph contain the azobenzene moiety as the photoswitchable unit. Euweuh baé nu kulitna alus saperti kulit sampéan. About this Item: Condition: Brand New. Photoinduced Motions in Azobenzene-Based Polymers 14.
Buy with confidence, excellent customer service!. Search Tips Our search has the following Google-type functionality: + addition symbol If you use '+' at the start of a word, that word will be present in the search results. Light can manipulate the orientation of optically sensitive chromophores containing polymeric thin films, and this phenomena has important applications to the field of opto-electronics and photonics especially in such areas as liquid crystals and optical storage of information. This is the same as using the minus symbol. Hal ini diperlukan karena saklar daya yang t… Asalamualaikum,. Contributor : Paul Rochon Contributor : Almeria Natansohn Contributor : Victor M. Ultrafast Dynamics in the Excited States of Azo Compounds3.
With Knoll's involvement, we can be confident that the best people in this field will be contributing to the reference. With Knoll's involvement, we can be confident that the best people in this field will be contributing to the reference. Nama Fb : Ceng Zamzam N. He is extremely well know for his research in this area. Electronic and Optical Transduction of Photoisomerization Processes at Molecualr - and Bimolecular-Functionalized SurfacesPart C - Photochemistry and Organic Nonlinear Optics8. May not contain Access Codes or Supplements.
Light can manipulate the chromophores' orientation by photoisomerization via polarized transitions such that centrosymmetry and isotropy are alleviated, and anisotropy and quadratic and cubic optical nonlinearities are induced. . Harper, Mingqian He, Albert S. This review should provide individuals working in the field of photonic polymers with invaluable scientific knowledge on the state of the art while giving directions for future research to those deeply interested. Ayeuna mah nginum téh cai kalapa. Third Harmonic Generation 367 12. Mao, Bo Wu, Lan Guo, Larry R.
To understand the photoresponsive properties of azobenzene and its molecular family, it is necessary to discuss their spectroscopy and the mecha- nistic options of isomerization. Zouheir Sekkat was a Postdoctoral researcher at Max Planck working under Professor Knoll. About this Item: Academic Press, 2002. All Optical Poling in Polymers and Applications 12. Surface Relief Gratings on Azobenzene-Containing Films 15. He is extremely well know for his research in this area.
Therefore, the first chapter of this monograph deals with the properties of this simple molecule and its simple derivatives. Wolfgang Knoll is a former Directory of Polymer research at the Max Planck Institute. Applications for various purposes are covered in some of the following chapters. Ultrafast Dynamics in the Excited States of Azo Compounds 3. Shipway Contributor : Henning Menzel Contributor : Takayoshi Kobayashi Contributor : H. We may ship the books from Asian regions for inventory purpose. Dalton, Antao Chen, and William H.


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Football agent Willie McKay tells BBC sports editor Dan Roan that Cardiff City "could have done more" regarding the travel arrangements of striker Emiliano Sala, who died in a plane crash in January along with pilot David Ibbotson.
Cardiff have previously stated they had offered to book a commercial flight for Sala.
READ MORE: Sala abandoned by Cardiff - McKay


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ED is a common occurrence after SCI, occurring in up to 80% of men, and results from disruption of the nerve pathways essential for erection (24,25). Different degrees of ED may occur depending on the spinal cord level of injury (LOI), extent of lesion and timing from injury. Reflexogenic erections can occur with lesions above L3 or L4 when the erectile spinal reflex arc remains intact. Psychogenic erections can occur with low lesions in the sacral and lumbar spinal cord but may not occur in complete lesions above T9 that can damage sympathetic outflow. Additionally, reflexogenic erections are not likely to occur in the spinal shock period that occurs after the initial cord trauma. Conversely, their occurrence may signal that the period of shock is over (26). Typically SCI affects younger men in their "sexual prime" and ED is associated with decreased quality of life (27).
To find studies on the link between meditation and erectile dysfunction (ED) you have to go way back. A 1977 study by Gerard V Sunnen at New York University on nine men with a mean age of 32 found that as little as two 15 minute sessions of meditation a day transformed the men so that all but two of them could achieve "erectile competence." The study worked by training the men how to deflect negative thought patterns from their mind through meditation.
Pay attention to your vascular health. High blood pressure, high blood sugar, high cholesterol, and high triglycerides can all damage arteries in the heart (causing heart attack), in the brain (causing stroke), and leading to the penis (causing ED). An expanding waistline also contributes. Check with your doctor to find out whether your vascular system — and thus your heart, brain, and penis — is in good shape or needs a tune-up through lifestyle changes and, if necessary, medications.
A study published in May 2014 in The Journal of Sexual Medicine found that some men can reverse erectile dysfunction with healthy lifestyle changes, such as exercise, weight loss, a varied diet, and good sleep. The Australian researchers also showed that even if erectile dysfunction medication is required, it's likely to be more effective if you implement these healthy lifestyle changes.
Viagra and Cialis, despite their aggressive marketing, are not the ideal treatment for men with psychological impotence. Rather, they are designed to treat physical erectile dysfunction that is rooted in blood flow malfunction. For the man with psychological ED, taking a pill may not work properly because they're not tackling the psychological causes of the problem.
Alprostadil, a drug also discussed in Penile Injection Therapy, has been formulated into a small suppository. This applicator is inserted into the urethra (the canal through which urine and semen are excreted), and with compression of the applicator, the small suppository is released into the urethra. With massage/rubbing of the penis, the suppository dissolves in the urethra and the medication is absorbed into the penis where it acts to increase blood flow into the penis. One cannot use any form of lubricant (for example, K-Y jelly, Vaseline, etc) to help with the insertion of the suppository. Urinating prior to inserting the applicator will help moisten/lubricate the urethra.
Impotence is a common problem among men and is characterized by the consistent inability to sustain an erection sufficient for sexual intercourse or the inability to achieve ejaculation, or both. Erectile dysfunction can vary. It can involve a total inability to achieve an erection or ejaculation, an inconsistent ability to do so, or a tendency to sustain only very brief erections.
One of the first steps is to distinguish between physiological and psychological ED. Determining whether involuntary erections are present is important in eliminating the possibility of psychogenic causes for ED.[2] Obtaining full erections occasionally, such as nocturnal penile tumescence when asleep (that is, when the mind and psychological issues, if any, are less present), tends to suggest that the physical structures are functionally working.[19][20] Similarly, performance with manual stimulation, as well as any performance anxiety or acute situational ED, may indicate a psychogenic component to ED.[2]
Alprostadil, a drug also discussed in Penile Injection Therapy, has been formulated into a small suppository. This applicator is inserted into the urethra (the canal through which urine and semen are excreted), and with compression of the applicator, the small suppository is released into the urethra. With massage/rubbing of the penis, the suppository dissolves in the urethra and the medication is absorbed into the penis where it acts to increase blood flow into the penis. One cannot use any form of lubricant (for example, K-Y jelly, Vaseline, etc) to help with the insertion of the suppository. Urinating prior to inserting the applicator will help moisten/lubricate the urethra.
Side effects include lightheadedness, fainting, priapism, urethral bleeding (intraurethral), dyspareunia in the partner (intraurethral), hematoma (intracavernosal) or penile curvature secondary to scar (intracavernosal). Efficacy of intraurethral alprostadil has been demonstrated to be around 50% ("able to have intercourse") in randomized controlled trials.31,32 For intracorporeal injection, typically alprostadil is tried alone, or compounded with papaverine (nonspecific phosphodiesterase inhibitor that increases intracellular cyclic adenosine monophosphate and cGMP) and/or phentolamine (competitive, non-selective alpha1- and alpha2-adrenoreceptor blocker). Pinsky et al33 reported an extensive review of the benefits and drawbacks of the combinations of these drugs.
MSA is a neurodegenerative disease of undetermined etiology, where ED is an early prominent sign occurring in 40% of men at the time of diagnosis (46,47). ED occurs in the majority of patients and the exact cause of it is unknown (48). Like PD, MSA likely affects the dopaminergic pathways within the brain essential for arousal (49). Orthostatic hypotension (OH) as a causal factor has been refuted by evidence that sildenafil can overcome reduced filling pressures, and the ED usually precedes the development of OH (46,49,50). Similar to other neurologic disorders that lead to ED, other disease related factors such as psychosocial stress, the burden of chronic illness, changed appearance, fatigue, decreased fine motor movement of fingers, immobility and diminished self-esteem due to loss of independence may contribute as well (51).
Ultimately, PDE5i have had a significant impact on the treatment of ED in men with SCI. The ease of use and tolerability of the medication has also led to improved satisfaction and quality of life that had been previously affected by SD. Head to head trials evaluating specific PDE5i within the SCI population are required to further elucidate drug preference. PDE5i should be considered first line therapy, however men with high thoracic and cervical lesions should be warned about an increased chance of dizziness with sildenafil and possibly other PDE5i use.
Finally, gene therapy and stem cell research has widened the frontier of ED treatment proposed as possibility to even reverse ED. Specifically, gene therapy pertains to repairing the cause of ED by restoring defective gene function and/or altering the expression of the mutant gene (32). Most of the available data on gene therapy are in the animal model. However, a phase I clinical trial in men with ED undergoing intracavernous injection with a DNA plasmid carrying the alpha-subunit of the corporal smooth muscle Maxi-K channel showed promise in increased erectile function based on IIEF assessment sustained throughout the 3-month study period (122).
…that relieve erectile dysfunction (impotence) in men. Two common commercially produced PDE-5 inhibitors are sildenafil (sold as Viagra) and vardenafil (Levitra). PDE-5 inhibitors work by blocking, or inhibiting, the action of phosphodiesterase-5 (PDE-5), an enzyme naturally present in the corpus cavernosum, the spongy erectile tissue of the penis. Under…
Prior to the introduction of PDE5i in 1998, intracavernosal vasoactive medications and penile implant surgery were the mainstays of treatment. Penile implant surgery involves placement of inflatable or malleable rods within the corpora cavernosa to provide rigidity for intercourse. Choice of which implant to place usually depends upon manual dexterity and function of the patient, patient anatomy, physician preference and surgical approach.
There are many different treatment options for erectile dysfunction but your individual diagnosis will determine which treatment option is right for you. It is important to realize that not all treatment options will work for everyone. A doctor who has specialized in men's sexual health (typically a urologist) will be the most qualified to discuss all of your treatment options with you. Many specialists will often encourage you to schedule additional follow up appointments to review how your treatment is working for you or if a different option may be more beneficial.
There are many alternative impotence treatments available but many of them are neither licensed nor legitimate, Beware of sellers offering "herbal" impotence treatments - these remedies do not work and are often sold illegally. You should also be wary of online sellers who offer Viagra and other prescription drugs without asking you for a prescription. Illegal pharmacies often sell counterfeit or fake medication and buying from them could put your health at risk.
You should talk to your doctor about possible treatments. You may want to talk to other patients who have had the treatment planned for you. You also may want to seek a second doctor's opinion about surgery before making your decision. You may find it difficult to talk to your doctor about impotence. You will want to find a doctor who treats this condition and will help you feel comfortable talking about the problem and choosing the best treatment. You can also get more information by contacting your local National Kidney Foundation affiliate.
The development of an erection is a complex event involving integration of psychologic, neurologic, endocrine, vascular, and local anatomic systems. Positron emission tomography scanning studies have suggested that sexual arousal is activated in higher cortical centers that then stimulate the medial preoptic and paraventricular nuclei of the hypothalamus.5 These signals ultimately descend through a complex neural network involving the parasympathetic nervous system and eventually activate parasympathetic nerves in the sacral area (S2 to S4).
Penile erection is managed by two mechanisms: the reflex erection, which is achieved by directly touching the penile shaft, and the psychogenic erection, which is achieved by erotic or emotional stimuli. The former uses the peripheral nerves and the lower parts of the spinal cord, whereas the latter uses the limbic system of the brain. In both cases, an intact neural system is required for a successful and complete erection. Stimulation of the penile shaft by the nervous system leads to the secretion of nitric oxide (NO), which causes the relaxation of smooth muscles of corpora cavernosa (the main erectile tissue of penis), and subsequently penile erection. Additionally, adequate levels of testosterone (produced by the testes) and an intact pituitary gland are required for the development of a healthy erectile system. As can be understood from the mechanisms of a normal erection, impotence may develop due to hormonal deficiency, disorders of the neural system, lack of adequate penile blood supply or psychological problems.[18] Spinal cord injury causes sexual dysfunction including ED. Restriction of blood flow can arise from impaired endothelial function due to the usual causes associated with coronary artery disease, but can also be caused by prolonged exposure to bright light.
Alprostadil, a drug also discussed in Penile Injection Therapy, has been formulated into a small suppository. This applicator is inserted into the urethra (the canal through which urine and semen are excreted), and with compression of the applicator, the small suppository is released into the urethra. With massage/rubbing of the penis, the suppository dissolves in the urethra and the medication is absorbed into the penis where it acts to increase blood flow into the penis. One cannot use any form of lubricant (for example, K-Y jelly, Vaseline, etc) to help with the insertion of the suppository. Urinating prior to inserting the applicator will help moisten/lubricate the urethra.
Alprostadil may be delivered via the urethra in the form of a pellet (MUSE) (107). This form of therapy has been trialed in SCI men with intermediate success (108). Bodner trialed MUSE dose escalation in SCI men and found 1,000 μg to be the most effective dose. Several men had hypotension when a constriction ring was not used in conjunction with the MUSE therapy.
Yohimbine: The main component of an African tree bark, yohimbine is probably one of the most problematic of all natural remedies for ED. Some research suggests that yohimbine can improve a type of sexual dysfunction that is linked with a drug used to treat depression. However, studies have linked yohimbine to a number of side effects, which can include anxiety, increased blood pressure, and a fast, irregular heartbeat. Like all natural remedies, yohimbine should only be used after advice and under supervision from a doctor.
In patients who either fail to respond to first or second-line therapy, or are not interested in the conservative therapies, penile prosthesis implantation is available. Malleable and rigid implants were available for many years, but in 1973 the world of penile prosthetics took a giant leap forward with the advent of the inflatable penile implant. Most implants done nowadays are of the inflatable variety. Adverse events including malfunction and infection are rare, and patient satisfaction is very high.45
The pathogenesis of organic ED is related to dysfunction of the endothelium. Endothelial cells can become injured through a variety of mechanisms, most of which cause oxidative stress on the tissues. Many of these causes of oxidative stress are related to lifestyle issues which lead to hypertension, diabetes and dyslipidaemia (figure 1). Endothelial cell dysfunction results in reduction of endothelium-dependent vasorelaxation as well as increased adhesion of leukocytes to the endothelium. Endothelial cell injury then leads to a variety of sequelae, including ED, other types of vasoconstriction, atherosclerosis and thrombus formation.18
In the 14 years or so since Viagra was introduced in 1998, the number of men diagnosed with erectile dysfunction (ED) has increased by a whopping 250 percent. Men are realizing more and more that they're not alone and that they have options. Aside from pills like Viagra, Levitra, and Cialis, for example, there are surgical, therapeutic, even do-it-yourself treatments that can bring back that lovin' feeling. "Some older ED treatments are actually being used more than ever, especially for men who can't take the pill," says Michael Feloney, MD, a urologist at the Nebraska Medical Center in Omaha. Read on to find out about nine common remedies for ED, plus the truth about which ones live up to the hype and which fall flat.
Are you having trouble sustaining an erection during sexual intercourse? As many as 50 percent of men over 40 have been there, too. As millions will attest, erectile dysfunction can be deeply frustrating and have a negative impact on both relationships and self-confidence. The good news is that there are many ways to treat erectile dysfunction, from simple lifestyle changes to medication to herbal remedies. If you want to know how to overcome erectile dysfunction so you can feel happy in the bedroom again, keep reading.


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Melissa Etheridge Announces Cannabis-Infused Wine
When singer-songwriter Melissa Etheridge stepped into the musical mainstream in the early 1990s, she brought the world a collection of music that many people consider timeless contributions to the American soundtrack. A decade later, she was diagnosed with breast cancer, and openly admits to taking advantage of the medicinal benefits of marijuana to help ease the nausea and loss of appetite from chemotherapy.
"I believe this is a huge opportunity," said Etheridge in a recent interview with Bloomberg's Pimm Fox. "A huge business and a huge market. You're going to see my name with a lot of these things. I actually have a wine that's coming out. It's a cannabis-infused wine, which actually tastes amazing."
Etheridge, who has just released a new album, entitled, This Is M.E., took the stage for a show at Albany's Egg Theater earlier this year, where she took the opportunity to speak out about the importance of bringing medical marijuana to New York. "As a cancer survivor, I know the ravages of a serious illness, and patients who are suffering deserve access to a medication that can provide them relief," said Etheridge. "Tonight, I stand with those patients, with their caregivers, and with the vast majority of New Yorkers who support medical marijuana."
During the Bloomberg interview, Etheridge said that she highly recommends cannabis for anyone who is suffering from the negative effects of cancer treatment and that she hopes to soon bring her cannabis-infused wine to all medical marijuana states. "I really look forward to bringing this to the world in a not scary way," she said. "Not a drug outlaw way. It's not that anymore. This is an American business that really needs a lot of help."
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Acrylic Tree Hammock By Novica
Great Acrylic Tree Hammock By Novica is necessary have in virtually any home. You would like to find the best pieces, and also you want to make sure you never ever pay too much to them. Appears to be a little challenging, right? Well, this post is in this article to assist. Continue reading and locate some terrific specialist techniques for choosing the discounts on household furniture pieces you will adore. Before purchasing any cabinets, wide open all of the storage and search on the inside. You're not only making sure that all of the compartments are built to final and open without any hitches, you should also make sure that the inside of the storage have some sort of doing at the same time. When buying Acrylic Tree Hammock By Novica, calculate your bedroom before going shopping. There is practically nothing even worse than picking out the perfect list of Acrylic Tree Hammock By Novica only to find that it will not easily fit in your master bedroom as soon as you obtain it residence. As an alternative, precisely measure your areas proportions before you go noting where entrance and home windows are placed.
Top Best Hammocks Reviews
Everybody wishes to possess a club in their home! Getting a drink in your individual club is much more thrilling than sitting on the sofa. The sofa does not provide the exact same sensation! There are several individuals, who build the club of the dreams but they are uncertain about the type of barstools that they can purchase. If you ask us, you should buy the correct bar feces. It should be visually attractive, helpful and comfy. You may wish to buy stools for your cafe or your homes bar. You have to maintain few things in your mind before buying the right bar stools. These days, we are going to cover the guidelines for buying for leather barstools. Also, we've produced a summary of Top Ten Leather-based Bar Stools. Their list has evaluations of every bar feces which will help you pick the perfect one. Read on to discover and decide. Searching for the best bar stool for your home? Nicely, you have to feel the list to get an concept. We're sure that you will find what you should want for in this list! We have covered the important thing features to help you make a choice. The good thing is available these bar stools online! These can be sent to your home within few days. So, feel the checklist and pick the best.
1.Double Camping Hammock with Stand By Vivere Hammocks
Read more about Double Camping Hammock with Stand By Vivere Hammocks
If youre searching for some serious rest, this loveseats strong cushion back and rolled arms will deliverbut at a higher cost. Every chair cushioning consists of 30 individual pocketed coils for springtime and assistance, and resilience chair foam for an extra coating of plushness and sturdiness. In addition, the froth soft cushions are capped with super soft, blended down feathers. For your additional comfort, there are 3 standard jobs: sitting, a slight recline with an raised foot rest, and a complete lie down by having an elevated footrest. It doesnt hurt this lying loveseat looks lux, possibly. Its all-leather furniture and decorative toe nail head cut provide a vintage appear that can work with lots of house dcor styles, from traditional to nation to arts and crafts. Plus, leather stands up nicely towards everyday use, kids and pet hair and fingernails. Just remember to condition the leather every 6 to twelve months.
2.Cotton Chair Hammock By Blue Sky Hammocks
Read more about Cotton Chair Hammock By Blue Sky Hammocks
Coming in at below Dollar300 (plus shipping) and 56 inches in width, our pocket book- and room-pleasant choose is ideal for very first apartments, playrooms, dens or any other small areas. Simply because its upholstered with additional strong bonded leather, this lying loveseat is more resistant against stains, releases and holes. Customers explain this reclining loveseat as comfy, fashionable and an excellent value. One reviewer wrote that it was one of the most comfy furniture pieces shes ever endured, whilst another said he could not have requested much more for his cash. Fair warning, though: some testers stated the furniture on their loveseats took effortlessly. Thankfully, the maker has a warranty for components. As this loveseat has such a simple design, it makes a solid foundation for more personalized decorations products. Add some decorative throw cushions or covers to up its comfortable factor, and give a few jumps of colour and pattern.
3.Bean Swing Chair with Stand By Modway
Read more about Bean Swing Chair with Stand By Modway
You cant talk about this couch with out talking about its remarkable style, sturdiness, and comfort. If you ever required a comfortable seat, then transfer fast and obtain your self Rollercoaster Samuel Collection Lotion Leather-based Sofa. You'll like it. This 3 seater sofa has thoroughly clean outlines and great soft cushions. The soft cushions are attached to the seat and behind. It is made from leather and that definitely is a sure bet that its long lasting. Additionally, it features tufted back again and chairs that certainly contributes to its remarkable appear. More importantly, it features a springtime foundation that provides the necessary comfort and durability. Its wood body causes it to be really sturdy. The long and the short of it is that this couch is extraordinary in each and every element. You might or might not accept this. But the only method you can understand why is to buy and try it.
4.Polyester Tree Hammock By Algoma Net Company
Read more about Polyester Tree Hammock By Algoma Net Company
This RTA loveseat provides various kinds of furniture depending on the material. That significantly incorporates linen and velvet. Sophisticated tones, Marzipan, Stoneware-Beige and Rye-Brown improve the style of the sofa. Choose the covering and also the material that depends around the stylistic design of your room. Not just the shading, the fabric can also reflect the main difference in style. Make sure that the material you select fits the concept of your room. This loveseat votes in favor of combining the current design by having an excellent design. It has been increased by the hands that start to pass through the sofa. With this blend, you simply witness improved comfort and tasteful style when lighting the pads.
5.Alicia Polyester Chair Hammock By Freeport Park
Read more about Alicia Polyester Chair Hammock By Freeport Park
This RTA loveseat offers different types of furniture depending on the material. That considerably includes linen and purple velvet. Sophisticated shades, Marzipan, Stoneware-Light tan and Rye-Dark brown enhance the style of the sofa. Choose the shading and the material that will depend around the stylistic style of your room. Not only the covering, the material can also mirror the difference in fashion. Make sure that the fabric you choose fits the theme of your space. This loveseat votes in support of mixing the current design with an excellent style. It's been moved up through the arms that begin to feed the sofa. With this particular mix, you simply see improved comfort and ease and stylish design when lighting the pads.
6.Kiersten Double Tree Hammock By Freeport Park
Read more about Kiersten Double Tree Hammock By Freeport Park
Much like its namesake, the camelback couch has a difficulty or maybe two that highlights the primary outline of the couch style. This can be a traditional style which was made popular in the 1700s by Chippendale and households who desired aristocratic, formal Kiersten Double Tree Hammock frequently opted for this design. Today, this couch style lends a more official atmosphere to the space, particularly when upholstered inside a official material. A more casual textile choice will make it suitable for a household room that doesnt need a great deal of formality. Either way, the camelback couch has some factors that define the style. The legs are usually exposed, the sofa doesn't have back again cushions and it normally has sq . or folded arms.
7.Bean Swing Chair By Modway
Read more about Bean Swing Chair By Modway
Weighing under $300 (in addition delivery) and 56 inches wide, our pocket book- and space-pleasant choose is fantastic for first apartments, playrooms, dog dens or other small spaces. Because its padded with extra powerful bonded leather-based, this lying loveseat is much more resistant to unsightly stains, releases and tears. Clients describe this reclining loveseat as comfy, stylish and an excellent value. 1 rater authored it had become probably the most comfortable furniture pieces she is ever had, whilst an additional stated he couldnt have asked for much more for his money. Fair caution, although: some reviewers said the furniture on their loveseats took effortlessly. Fortunately, the manufacturer includes a guarantee for components. As this loveseat has this type of easy style, it makes a solid foundation for additional customized dcor products. Add some ornamental toss pillows or blankets to up its cozy factor, and add a few jumps of colour and design.
8.Cardona Striped Sunbrella Double Tree Hammock By Red Barrel Studio
Read more about Cardona Striped Sunbrella Double Tree Hammock By Red Barrel Studio
Carolina Light Gray Material Sectional Sofa is celebrated for its spectacular comfort and ease and impressive design. It has a lift-up style that allows for many agreement options to suit your needs.The established features gentle material and pushes soft cushions to create the specified comfort. More importantly, its of the good size to accommodate you along with the family of friends. Depending on the available space and your desired shape, you are able to combine the I seats to create a remarkable form. Its highly recommended for those with small areas and requires a sofa.
9.Sunbrella Soft Comfort Chair Hammock By Algoma Net Company
Read more about Sunbrella Soft Comfort Chair Hammock By Algoma Net Company
The best part that compensates for that time lost the glory from the purchasers is its design effortlessly. Just for the look of the upholstery, you get a nice stylish atmosphere. It comes in rich solid shading, imitating as amazing formal clothing. While keeping an honorable stature, the fabric upholstery could be washed very easily. You should not rue following generating a cup of consume on your nice sofa. You just need to wash the stain without end exactly if this hits the furniture. Despite the fact that great repute accompanies delicacy, it is not the situation here. This amazing couch is fed having a contour growth and development of wood. You are much more reluctant to listen to squeaks and walking sounds.
10.Goins Polyester Fabric Chair Hammock By Winston Porter
Read more about Goins Polyester Fabric Chair Hammock By Winston Porter
This set is padded in a drive and comfy textured cushioned purple velvet. This gives it the amazing comfort that it is loved for. Again it facilitates chaise style seating for sufficient comfort and ease. Moreover, the nose spring base adds to the comfort and durability. Furthermore, the couch has hard wood structures that add to its toughness and durability. The sofa has soft cushions on both the seat and also the back again. But still, the sofa can change from a seated placement to some reclined placement easily. That said, just to replicate, the couch is very gentle and gives exceptional comfort.