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Broad chest, weak lungs - Are men more prone to respiratory diseases?The long-standing, chronic afflictionof the respiratory disease is called as COPD, i.e., Chronic Obstructive Pulmonary Disease. COPD is the obstruction within the lung tissue, causing improper circulation and entrapment of air. This limits the space for air to move in and out, directly affecting the quality of inhalation. A small reminder here may be necessary - breathing is synonymous with life, why? Because that's how we get oxygen, which is vital for the functioning of each and every cell within the body. With COPD, the ability to take in oxygen gets compromised increasingly. Continued cough, sputum, and shortness of breath are the main symptoms. COPD is more common in men. Does it have to do anything with being a male? Not necessarily. No specific link has been established to say that COPD risk is higher for you solely because you are a man. Then, what could it be? A study conducted in 2011 in USA showed that the number of men who smoke is 5% more than the women who do. To understand the reason behind this, let us see the primary causes of this disease. Air pollution, some genetic predispositions, frequent acute infections, exposure to harmful chemicals for a long time (usually occupational) - are some of the main causes, and the number one cause is smoking, owing to almost 80-90% of the cases. Park this thought. Next piece of information is simply revisiting some facts you may already know: #The gender classification ofsmokers - Men are known to smoke more than women all over the world, not only in numbers, but also in quantity. Whether it is a developing country or a developed one, 2011 studies say there are more male smokers everywhere than female smokers. Not only there are more men who smoke, they smoke for longer periods and more number of cigarettes than female smokers. This may vary from country to country, like India has much less women smokers than USA does, but the difference between the two genders holds true everywhere, only the ratios differ. #Occupational exposure to harmful chemicals and gases - These are industries of mining, textile, chemical engineering, welding, etc. The number of men working in such industries is way higher than women. #Air pollution - Men are more exposed to air pollution since they are outdoors more than women. This may not apply to all countries and societies, but is generally true. Now, we can put the pieces together and understand why COPD is more common in men? Yes, they are at a higher risk because of higher exposure to smoking, pollutants and irritants. Cigarette smoking is the leading cause of lung diseases and male smokers outnumber women across the world. You can figure out the math here!
Infertility at workplaceSince infertility among the younger age is increasing, it is important that a couple decides an early suitable date to attempt conception. Time and again it has been found that infrequency of intercourse is the cause of delayed pregnancy. It is advisable that the woman has a thorough examination by the gynecologists to identify the ovulation dates and for the man to have a thorough spermatic fluid check.  If both are normal then they could wait for a suitable date later. Should there be a problem the quicker it is attended to better. Also, early in the marriage they should start a fund which could be utilized for matters related to conception. For the male, the main treatment covers his personal sex life and a detailed examination of his spermatic fluid. It is the female who has to undergo many detailed tests and possibly surgeries which are expensive. It is often seen that not only the procedures for both take a toll on their personal and intimate relationship but also severely affect their finances which may come to a point that it does not allow them to complete the treatment as for e.g. the woman undergoing IVF may costs several lakhs of rupees. The treatment of infertility has improved greatly, but interferes severely with the work schedule. Working couples particularly women may have a hard time keeping to their schedules. Depending on their infertility diagnosis, many workplace challenges exist including the need to take time off to undergo tests and other appointments. It is difficult to balance the medical and surgical procedures with daily life and work. This is a difficult issue for many people as they fear their employer may discriminate against them for taking time off from work. Sadly in India there are very few employers who include medical benefits and cost of treatment for infertility. Suggestions have been given on stress dealing with infertility treatment and work. Here are few pitfalls to avoid: Do Your Homework: Review your organization's HR policies so you understand the amount of leave you have and other policies that pertain to your situation. You may be able to arrange for flex time or work from home on the days of your appointments, so that you do not actually miss any work. Be Honest:  Go to supervisor and let her or him know that you will be using your leave time and will give as much notice as possible. Honesty is the best policy. Remember people are inherently curious about the disease of infertility. If you feel the questions are invasive and make you feel uncomfortable, remember you do not have to answer the questions. You can respond nicely and let them know that you appreciate their concern but you are not ready to answer any questions. Your co-workers are asking question because it is human nature to be curious. In conclusion, not everyone needs to know what is happening with your reproductive health. At work place should medical help be available do take advantage of it.  This treatment has nothing to do with your performance at work. Go to work feeling confident that you will be able to perform your job and handle your workload during this time.
Hairy tale: Hirsutism in womenThe condition is called Hirsutism where women grow coarse hair just like males on the face, chest or elsewhere. The primary cause for Hirsutism is hormonal imbalances by the over stimulation or excess production of male hormones (present in minute quantities in females too). The thickness of hair that grows largely depends on our genes and at times Hirsutism in women may be just a hereditary trait rather than an imbalance. Self care and medication can take of it in such a case. Idiopathic Hirsutism is a type of this condition where there is no possible cause for the male type hair growth. These women have regular menstrual cycles and no Androgen excesses, yet they have Hisrutism. Hirsutism with excessive bodily and facial hair, usually in a male pattern, in women may be present in normal adults as an expression of an ethnic characteristic or may develop in children or adults as the result of androgen excess due to tumors, or of non-androgenetic or other drugs. Hirsutism can make its appearance at menopause or soon after as there are a lot of hormonal changes that occur in the female body, and in certain cases women grow hair even on the lip, nipples, abdomen and upper shoulders. And just as men go bald there can also be a receding hairline and baldness in women accompanied by a deepening of the voice and enlargement of the clitoris. If the hair growth occurs at puberty then a doctor's evaluation is most essential as it could be more than just Hirsutism.
Pediatric diet formula food vs traditional foodAccording to the World Health Organisation, it is unnecessary to give your baby rice cereals at the age of four months as breast milk can provide all the nourishment a baby needs in the first year. No other solid food is required. Breast milk has all the nutrients like fats, protein, cholesterol, carbohydrates, vitamins and minerals which are required in the first year of life. According to most studies,formula foods are not the healthiest option to begin solid foods on. Doctors prefer that babies be given boiled vegetables and mashed fruits like bananas and not formula cereals that contain simple carbohydrates. It is not a good idea to give babies processed and refined foods that are found in all formula foods. Formula foods do have nutrients, but they are not as easy to absorb as nutrients from foods prepared at home. You can also ensure quality in food that is prepared at home. Formula foods cannot imitate the natural taste of foods. Babies like to choose foods according to taste just like the adults and you can give them a wide variety of choices like offering them different fruits and vegetables rather than the similar tasting formula. You will be surprised to know that mother's milk has the taste of the foods she eats and so babies develop taste for a variety and may like the insipid taste of formula. Another reason why formula foods may not work that well is that they contain cereals. However, the enzymes that are required to digest carbohydrates are not fully developed in babies until they are more almost three years old. Cereals and breads are very difficult for babies to digest. Undigested grains can throw off the balance of bacteria in the gut and this is the reason for a lot of digestive issues once they are grown up. Solids should not be introduced until six months of age, as studies now reveal that if solid foods are given early on then it increases the likelihood of allergies, especially of those foods introduced. Babies produce only few enzymes and digestive juices that are mainly required to digest protein and fats. This is because mother's milk has 50 to 60% healthy fat which is a must for the babies' mental and physical growth. Most baby infant nutritionists feel that formula feed is not a complete food. Babies will get deficiency,such as iron, as it is difficult to absorb them from formula foods. The debate continues as many feel that the marketing gimmicks are what selling these foods and not the nutritional value they provide to babies. A note of caution, excessive amount of juices are harmful for babies as these can lead to obesity.
Avoiding nappy rash - A few words of adviceNappy rash is a skin condition that takes its name from the nappy in which a baby is wrapped. It is a reddish rash, or tender skin around the buttocks and inner thighs of babies, which occurs due to prolonged wetness from either urine, or stools, or both. Nappy rash may be in the form of an unusually tender bottom on a child, or an inflammation around the genitals, and inner thighs, or folds of the skin. It generally occurs in really small babies, less than a year old. Most times, nappy rash is not a very serious condition, provided care is taken. No matter what type of nappy you use, whether promising complete dryness, or absorbent nappies, your baby is likely to develop 'nappy rash' at least once. The rash can make the baby feel uncomfortable, and cranky as a result. Steps to avoid nappy rash: Always ensure that your baby's bottom remains dry by changing nappies at regular intervals. Use a mild medicated baby soap which will help in keeping the skin around the inner thighs and buttocks soft. Give your baby some nappy free hours. You will be the best judge to know when she is likely to have comparatively dry spells, which can allow the skin and parts below the waist some breathing space. Regular bathing should take care of most rash related problems. Use an emollient, or medicated soap for bathing. Sometimes, nappy rash is a result of a thrush or yeast infection. The baby's resistance at these times is low so that it allows the yeast to thrive in the form of ugly red patches. Always show a medic to rule out the possibility of bacterial infections. Anti-fungal creams should also take care of normal nappy rashes.    
Communicate to strengthen the family tiesA family that talks to each other stays together. Sounds easy? But how often does your family sit down together in the week to spend time with each other? How about breakfasts and dinners? Are you all able to match your meal times or are you catching each other by the end of the coats in the fast paced world that has us spinning us on our heels constantly? As the family members run in and out of the house, like in a hotel, engulfed in their daily routines they slowly start drifting away from each other. Somewhere pushed to the depths of the heart are old connections and affections with the family. Ideal conversations during childhood, encouragements received during tough times, sibling squabbles in adolescence and many a wonderful memories tug at the heart keeping the family from disintegrating altogether. On the contrary, improper communication and bottled feelings singe the heart in such circumstances and lead to the tumbling of the family ecosystem. Understanding how to build effective communication within the family is important as it helps build a stronger, inseparable family. Here are some effective practices: Communicate Frequently:With the limited time that you have with your family, make communication a common and frequent activity.  While traveling in the car, during meal times, replace TV time with talking, talk to your young ones at bedtime. Keep designated time for informal family meetings and encourage conversations among the family members. Keep the cell phones and laptops in the other room when the whole family is sitting together. Communicate Clearly and Directly:Develop an environment where the family members feel okay to communicate clearly and directly. Allow them to express their thoughts and feelings without having to mask and filter them. This is important in a parent-child relationship and sibling-sibling relationship. It also helps build confidence, family intimacy and bonding among the family members. On the other hand, veiled, indirect or vague communication is ineffective and harmful as it increases confusion and communication gaps. Active Listening:Open and free communication flows only when it is received well and the other person's perspective is acknowledged and respected. Active listening is the cornerstone of effective communication. Whether listening to your partner or child, it is necessary to pay attention to not just the words but tell-tale signs in the tone of communication and non-verbal messages too. Nodding of the head, or words of acknowledgment like, "I understand" make the other person feel that what they are saying is valued and received. Asking questions and requesting clarifications for the parts of the message you do not understand is a very important part of active listening. Trust and Honesty:Only when the family members feel that they can trust each other, can they communicate honestly. Trust is the key for strong familial relationships. Trust is propagated through openness and honesty. Understanding the Individual:The way each individual of the family feels and communicates is different. The way you communicate with the different family members should vary accordingly. Especially in case of young children, as their maturity levels are different than the young adults and adults in the family. The unspoken messages:Not everything might be said in words. Learning to read non-verbal communication such as expressions and body language are very important in understanding the entire message being conveyed to you or the parts being held back. Stay Positive:Many complications and problems between family members can be avoided or solved by effective communication. When dealing with undesired or negative situations, it is important that the words and tonality of the communication is positive. Avoid engaging in negative communication like criticism, defensiveness or contempt. Such negative communication patterns discourage communication.Communication is essential to successful family functioning. Taking inventory of how well the family is doing and readjusting course and practices will help improve the family environment and build a happy family that shares openly and honestly with each other.
Expression forbidden! - Human emotionsSome people have a perpetual 'bee in their bonnets'! They maintain a demeanor and a mask which is virtually impenetrable. They are generally highly competent and efficient and occupy high positions of authority. They believe in living life set to a routine, and the worst part is that they expect others to adhere to it as well! God help those who have a boss like that, as their immediate liberty is at stake, and unless they are honing to be perfectionists, life is going to be a series of disasters with Captain Ice around! Nothing wrong with perfectionism per se, but when someone is a hard task master then he could well earn himself the epithet of being "a crashing bore," especially if he doesn't allow others to express themselves properly. Take a more intimate scenario - Mr. Bright Harry meets tepid Sally. The sparks fly only on Harry's side with Sally stonewalling his every effort to get to know her mind, body, and soul. A tough ask for poor Harry, as he is yet to touch first base with Sally. Know what? They have been married 5 years and she seems to be fond of him, yet has never as much admitted it to him. Quite frankly, the two could pass off for siblings rather than 'man and wife.' Why are some people such rotten spoilsports, especially where emotions are concerned?  It may well be a natural mindset for some to have an emotional guard up and emote, or have an emotional connect only with certain types of people. Fair enough and good show, we say! After all one can't be wearing one's emotions on a sleeve or you end up been taken advantage of. That's a mask that most 'tough guys with soft centre' wear anyway. Nowadays with the rules being somewhat relaxed with men been given liberty and allowances to display their gentler feminine emotional side, we find men going over the top with the sheer display of emotional expression. One is at sea wondering which one was worse off-the tough, cynical cop look or the "let me weep my heart out for you" kind of contrived emotion. That apart, it is bad enough for us having to contend with a person who has difficulty with expressing himself properly. We don't mean articulation or even well-developed linguistic ability - we mean being able to be spontaneous and congenial and a little forthcoming and nice to be with sort of an emotional person. So, unless someone has a romantic angle towards this guy (there are weirdoes all over the world, who go asking for it!) or girl, he is going to be feared, hated, despised, unloved, and uninvited by everybody. So why do people behave like they are going to be flogged for even attempting a ghost of a smile or a cheerful greeting to a fellow co-worker? Why do some people find it difficult even to open up on a psychiatrist's couch? The Mask The most common reason for Mr. or Ms. Grumpy is that they have probably been emotionally brutalized in their formative years by an authoritative parent and this has caused them to lock themselves up double quick in a shell and throw away the key. Now, that can be tough and extremely painful. It is a prison of their own making through which nobody can see that once bright-n-chirpy personality frozen, much like the curse of the wicked witch in those fairy tales we read. The person is dying to let his emotions out and let people see who he is, but since very little light escapes out due to the tough mask and veneer, that it is an uphill task. Then the sheer anger at not being understood, subconsciously plays havoc and then he gets to be the more demanding boss at work or that sullen wife or lone stranger staring in to nothingness on the park bench. These are the people that have a series of relationship disasters as their defence mechanisms are too solid to be penetrated. Some people may be naturally distant, and for them the finer and higher emotions probably don't register as much as they do in the average person. These guys are cut out for careers ranging from lighthouse keepers to morgue attendants to hangmen, where being emotional has no place. There are still others who swing the other extreme by showing so much of emotion that it is scary for others to take them on. Their emotional side is so overwhelming and demanding that it is actually a clever subterfuge on their part to drive people away as they subconsciously do not want people to get to know their real side. They generally don a mask of humor and good cheer and are great fun to be with. In reality, they are alone and scared and perhaps hurt emotionally. So, they feel safe to display emotions to masses rather than individuals. These people make good evangelists and rock stars as they can safely display and get an emotional discharge without running the risk of a one-on-one emotional exchange where they are afraid they would be hurt. If you encounter such a person who looks askance at you displaying your emotions, then it is better for you to talk things out and maybe put things in perspective. Of course, this all depends on whether you are emotional enough to maybe give someone a chance by understanding what drives them to do the things they do. Let me assure you the ice will thaw if the intention is genuine and well meant.
5 tips to reduce your salt intakeSalt is an inevitable part of our food, but added salt has harmful effects on the body. The list of benefits in reducing sodium/salt intake in our diet runs long, ranging from lower blood pressure, in turn leading to reduced risks of heart disease, obesity, and diseases of the kidney. The daily sodium intake of an individual should not exceed 1500-2300 mg per day (a table spoon of salt approximately), and this needs to be maintained in the salt added to our food, including the processed food and drinks we buy. Sodium, an indispensable component of our diet, is consumed in excess by most of us. Follow the tips, as mentioned below, to curb your daily salt intake. Avoid added salt. Do not add salt to already cooked food while eating. Keep a diary and make a list of foods with salt in them that you eat daily. Do not forget to add pickles, spices, papads, salted biscuits, and salted nuts. All of these are highly loaded with salt. Next time you go shopping read the labels. Choose low-salt options-sauces, crackers, khakhra, instead of papad. Make an attempt to eat less canned and processed foods. Choose fresh fruits and vegetables over processed food. Eat less bread. Each bread slice has about 250 mg of sodium. Do not mistake bread to be healthy. Next time, keep this in mind when you go out to eat pizza. Pizza base is like bread. While cooking food, make it a point to add salt only towards the end in the recipe. This way you will need to add lesser salt. Sodium content of some foods Bread (one slice) - 250mg Cheese pizza: 450 - 1200mg Tomato soup: 350 - 1000mg Potato chips: 100 - 150mg
How to communicate with a patient who has a strokeThe first and the most important thing to communicate with the patient, is to give undivided attention. Give attention to his activities, gestures, his facial expressions through which he may try to communicate so his feelings could be understood. Eye contact is also important but the patient having stroke may look at you square in the eyes but he may not respond to your conversation. While communicating with the patient you should always stand in front and tune out all the other sights and sounds in the room. Maintain full silence around the patient in the room, turn down the volume of the television, radio and ask other people in the room to be silent. You may communicate with the patient by making contact by touching the hand, chin, cheek or areas which are not affected by stroke. As the side which is affected by stroke, does not have any sensations. You may communicate with the patient through his family member by telling the family member to communicate with patient by saying, "Look at my face"; through this we can gain the patient's concentration. You should always speak clearly with the patient in a normal soft volume. Express your ideas in simple terms, form simple sentences, do not use complex words. You may repeat the sentences or an important term again. For example to ask if the patient wants tea, repeat the word 'tea'. More complex thoughts can also be similarly conveyed and repeated. You may also use hand gestures with clarification like doing Hello by waving your hand or through your hand action, you may ask questions like, How are you? Are you ok? What do you want? Through this both caregiver and stroke patient can benefit. You may ask your patient to point out whatever he wants or if he needs anything. And gradually he will develop the habit of pointing the daily items like television, newspaper, remote, eyeglasses radio, drapes an uncomfortable foot, the patient can indicate any pain or headache. Through this communication we can make the patient learn, use mechanical lifts to get in and out of the bed, and with the help of the attendant by demonstrating the patient how to use it. Sometimes when the communication does not work, take a break, give it time and try again, do not get frustrated and reassure the patient that yes, he or she can do it. Good communication with the patient is very important as they cannot speak their basic wants and needs clearly. The patients suffered a stroke also have slurred speech. There is a deviation of the angle of mouth. They are mostly bed ridden and could not carry out the routine activities.
Aids defining cancersIn fact the presence of such aids defining cancers is an indication of advanced AIDS having developed in these patients. However, the reasons for these cancers are unclear. It is possible that since people with AIDS have low immunity, they become more susceptible to these cancers. The double attack of these already complex diseases complicates treatment plans too. Thus, it needs care under experienced doctors who specialize in these diseases. The cancers that define AIDS are: Kaposi's Sarcoma:This is a type of skin cancer. It was usually found usually in people who have received organ transplants. Nowadays it is also most prevalent in homosexual men with HIV/AIDS and is also called epidemic Kaposi's Sarcoma.  It causes lesions to show up in multiple points in the body such as skin, lymph nodes, liver, lungs, spleen and digestive tract. Non-Hodgkin Lymphoma:This is the second most commonly associated cancer with HIV/AIDS. The various sub types of NHL are primary central nervous system lymphoma and primary effusion lymphoma. Approximately 4-10% people with HIV/AIDS develop NHL. Other kinds of cancers are anal cancer, liver cancer, mouth cancer, Hodgkin's lymphoma, testicular cancer, melanoma, throat cancer, colorectal cancer and multiple skin cancers.  Treating Cancer in HIV people: Till anti-HIV medication were not discovered the future for infected people was bleak. They were already sick and their bodies weak even before their cancer treatment were started. Presently the cancer treatment is mixed with anti-HIV drugs. However, depending upon the extent of cancer and the need of AIDS care, variations are made between chemotherapy and other HIV related drugs needed. Treating Kaposi's Sarcoma: Often anti-HIV drugs are enough to treat this cancer. The lesions, which are viral, shrink, as the immune system gets better. Sometimes chemotherapy and radiation may also be needed if the lesions are internal. Treating Non-Hodgkin Lymphoma: AIDS related NHL is fast growing and needs intense chemotherapy treatment. Introduction of highly active anti-retroviral therapy and use of drugs that help the infected body make new blood cells has relieved a major concern for HIV patients where previously due to their low blood cell count, chemotherapy could not be administered to them. But with these advances, acutely monitored chemotherapy treatments can be administered now. Treating Cervical Cancer: In case of women who have a good immune system and invasive cervical cancer can still be treated similarly as non-HIV women. They can even do well in surgeries and other conventional treatments. Discovering Cancer Early: Screening helps discover presence of cancer when no symptoms are evident. However AIDS defining cancers cannot be detected through screening. Thus, close monitoring, regular checkups and a keen lookout for symptoms of these cancers can help discover the ailment if present. Pap tests help discover cervical cancer in women. However, in case of HIV women, these should be undertaken more often. Even as often as 2 tests a year, 6 months apart in the first year of HIV detection. If the tests are clear, they should get Pap tests done regularly once a year henceforth. For other AIDS related cancers, the screening tests are still being devised. Lowering Cancer Risk: HIV ruins the body's immune system making it susceptible to a variety of diseases. Good health practices are a must for those detected with HIV in order to ward off cancer. They should surely not smoke or consume alcohol. Injection drugs and unsafe sexual practices also pose increased threat of cancer. Maintaining balanced diets, physical activity and proper body weight are extremely important and helpful too.
Stress-free sex: Know your safe period!Having sex is a pleasurable thing; and the nicest way to enjoy it, is to give in without being bogged down by the fears of getting pregnant. Not every act of sexual intercourse will result in pregnancy. There are days when your chances of conception are very high, just like there are days when the chances of getting pregnant are almost nil. Identifying these days will help you enjoy a better and a more stressfree sex life! A woman's menstrual cycle starts from the first day of  bleeding and ends about 28 days after that, on an average. Ovulation occurs on the 14 day of the menstrual cycle. The 14th day is the ideal day, theoretically. Since every woman's menstrual cycle differs, the day of the ovulation also differs. Hence doctors calculate the fertile period from the 12th to the 18th day of the menstrual cycle. This is the period when the chances of ovulating and hence getting pregnant, are optimal. The 1st to the 7th day and the 19th day to the start of the next cycle, are the days when the ovulation chances are very low. This means if you make love during these days, there are very little chances of you getting pregnant. This is the case with women who have regular period cycles. In case your cycles are not regular, then you would need to do a bit of math to calculate your safe period. For example, if your shortest cycle is of 26 days and the longest cycle has been of 31 days, then: 26-18= 8 and 31-10=21, which means the 8th to the 21st day of your cycle, are the most fertile days. The 1st to the 7th day and then the 21st day to the start of your next cycle, are the days that are safe for you to enjoy sex, without fear of getting pregnant. Opting to have sex during the 'safe period', isn't always fool-proof though. A lot of women have irregular cycles and the cycle length can vary from woman to woman; which is why the so-called 'safe period', is in truth, not 100% safe. It is always better to use condoms or other contraceptive methods like the oral pill to prevent unwanted pregnancies.
Smoking causes impotence!Men who smoke heavily are twice as likely to suffer from impotence or erectile dysfunction. The link between smoking and ED has been established beyond reasonable doubt. Smoking causes a hardening of the arteries or blood vessels. For a penis to grow erect or tumescent there has to be a healthy blood supply. Now imagine the cross-section of a smoker's penis where there are plenty of blockages and hardening of the blood vessels. Can the penis then grow erect with so many hindrances to the blood? There is also an acute loss of sensitivity to the penis which is a direct contribution of smoking! Previously, alcohol was a hot favorite of the medical lobby when it came to 'impotence.' Wish smokers could say the same thing about moderate smoking! Even moderate smoking can make an existing condition of impotence worse. One could make changes to one's lifestyle and diet and curb stress to treat ED (erectile dysfunction), but all these will come to naught unless one really resolves to give up smoking permanently. Just within a few hours of kicking the butt, the body starts to repair itself. Of course, it may take longer for the blood vessels to actually undo the blockages and have a free run for the penis, but it will certainly happen, slowly and surely. Smokers may have an underlying condition of anxiety, which is made worse by nicotine, which in turn causes performance anxiety, not greatly helped by blocked blood arteries. So smoking not just makes you physically impotent, but also mentally impotent too. It is a powerful narcotic which is hateful to the body and spiteful to its salubrity. Please enroll into a 'stop smoking now' campaign with the help of friends or family. Check for any 'nicotine anonymous' programs in your neighborhood or just do it all by yourself. Otherwise, the only thing hard about your penis will be hardened arteries and lots of hard luck!
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