A Possible Physical Explanation For Trump's Mentally Unstable Behavior

"Goddamit! I am not insane! I am not! I just want the whole planet to follow my damned orders! BWAHAHAHAHAAA!"

Finally, an author has advanced a possible physical explanation for Donald Trump's insane rants, unhinged blowouts by tweet and over the phone, antagonizing most sentient people in the civilized world. As a recent editorial in The Barbados Nation put it:

"The greatest concern for the next four years –– if indeed Mr Trump’s sojourn in the White House lasts that long –– is his judgement, public conduct and practical vision for the United States vis-a-vis the rest of the world, and the likely fallout that would impact those of us in the Caribbean. Sadly, upon assuming the greatest authority on Earth, we have seen little metamorphosis in his shamelessness (groping aside),vanity and threatening image....

The brash United States leader might also take a Barbados Community College course in communications and diplomacy. Can you imagine Donald Trump this week slamming the phone in the ears of Australia’s Prime Minister Malcolm Turnbull after a testy exchange between them over a refugee deal signed with the Barack Obama administration? "

The author, urologist  Daniel Marchalik - writing in The Washington Post - described the cause as a potent side effect of a hair loss prescription called "finasteride ".  He wrote:

"President Trump’s personal physician recently revealed that the president takes finasteride, a drug used to combat male-pattern baldness. The medication has been in the news for another reason: its potential side effects. In fact, approximately 1,370 lawsuits have been filed against Merck, which markets finasteride. A class-action lawsuit against the company will examine the pharmaceutical giant’s culpability in the multitude of reported sexual side effects potentially associated with the drug. Merck did not respond to a request for comment..

He goes on:

The constellation of potential symptoms, sometimes referred to as post-finasteride syndrome, may include sexual, physical and psychological changes. Of these, the sexual side effects are perhaps the most extensively reported. In fact, in 2012, the Food and Drug Administration announced a label change for Propecia and Proscar, requiring the manufacturer to warn that the medication may be associated with “libido disorders, ejaculation disorders, and orgasm disorders that continued after discontinuation of the drug.”....

At the same time, a recent study demonstrated changes in the levels of certain steroids in cerebrospinal fluid of men taking finasteride for hair loss. These steroids have been shown to influence brain function, and their presence may help explain the profound psychological changes such as depression and suicidality that have been associated with finasteride use.

Merck sells finasteride under the brand name Propecia, a 1-milligram formulation of the medication. It is available as a prescription for treatment of male-pattern hair loss. Its big brother, Proscar, is a 5 mg preparation commonly prescribed for the treatment of symptoms associated with enlarged prostate, or benign prostatic hyperplasia."

The most salient observation was:

"Together, finasteride and a closely related compound dutasteride (sold under the brand name Avodart) are a class of drugs called 5-alpha-reductase-inhibitors (5-ARIs) which work by blocking the conversion of testosterone to its more potent form, dihydrotestosterone."

Recall, in one of my posts (July 17)  on hormone treatments for  prostate cancer I referenced chemical castration therapies. One of these entailed the secretion of luteinizing hormone-releasing hormone  (LHRH) which in turn stimulates the pituitary gland  to produce luteinizing hormone (LH) as well as follicle -stimulating hormone (FSH) . Then LH signals specialized cells in the testicles to secrete testosterone into the bloodstream. When testosterone reaches the prostrate it is converted into di-hydrotestosterone (DHT) a much more potent form of testosterone, via the action of an enzyme:5 -alpha reductase. The objective of medical castration then is to break this cycle, usually in one of two ways: 1) via  LHRH agonists or 2) LHRH antagonists.

In (1) the medication stops the testicles from making testosterone. This is achieved by inducing a continuous message from the brain to produce testosterone which over-stimulates the testes. They respond by being "overworked" so switch off.

In (2) the medication also induces the testes to stop producing testosterone but not by over stimulation. Rather it occurs by blocking conversion of testosterone to its more potent form.

The differences between the assorted chemical castration agents and their effects are discussed here for those interested:

https://www.youtube.com/watch?v=KtIfsvQh2qI

In thirty percent or more of these administrations, one of the primary side effects is a condition called gynecomastia which is briefly outlined via one case in this issue of The New England Journal of Medicine. (I warn all males, especially those now taking 'high T' supplements or shots, this may well be your future as I will show below!)

http://www.nejm.org/doi/full/10.1056/NEJMicm1209166#t=article

One is led to inquire if Trump is suffering from any of these symptoms, including impotence and large breasts and if these are causing him to go off like a gas-lit fire bomb every few days. We don't know but we do know these sort of hormone interventions can wreak psychological havoc  including severe depression and intermittent explosive disorder. Indeed, a number of men using these therapies have reported their ghastly effects on the prostate cancer survivor's group to which I belong: They include: blowing up at wives and gfs, making impulsive decisions which create chaos in their lives, and an inability to think clearly and settle in to work the tasks at hand. That includes lack of concentration to meet work demands, leading to low productivity.

In the case of Trump, as numerous leaks have revealed, we behold a guy unable to settle into the role demanded by the job of President. Instead, as shown yesterday a.m. (CNN presentation, with Frdericka Whitfield) this joker spends hours each day with eyeballs glued to the tube, starting with 'Morning Joe', then 'Fox n' Friends' and others. Some of the leaking staff members estimate he's at it nearly 7 hours a day. The only time they have him looking like he's doing anything is when he signs Bannon's "executive orders".

As one commentator of the piece said afterward: "You wonder how or when he is actually attending to the job."  And the real howler is that this character used to knock Obama for "taking so much time off".  Yet Trump can't even put in a full day at the office, and he left for his Mar-a-Lago holiday at exactly 2: 45 p.m. on Friday. Any ordinary employee leaving like that from a corporation might be canned the next day. A real pity the Donald can't fire himself. It would be the most heroic act he could perform right now, kind of like an honorable form of Hari-Kari.

But again, if indeed finasteride is the source of his  unhinged behavior, he is only to blame if he allows his narcissism and vanity to get the better of him. In other words, he needs to stop using the damned Propecia!  Far better to be a sober, respected chief executive who is in touch with reality but with pattern baldness, than a fully cropped orange-haired nut who can't even work an hour a day at the most important job in the nation. And - in the words of the Barbados Nation editorial - has inspired "gargantuan hatred".

See also:

http://smirkingchimp.com/thread/norman-solomon/71062/the-house-can-start-impeachment-against-trump-now

The Perfect (Alternative) Punishment For Entitled College Rapists Who Want To Avoid Prison Time?

Rapist Austin James Wilkerson - believed by many women to have gotten off lightly.

Women in our state, as well as prosecutors, continue to express outrage at the light sentence meted out to rapist Austin Wilkerson.  Wilkerson, 22,  a former University of Colorado student, was sentenced last Wednesday to two years of county work release for the 2014 rape of an alcohol -impaired coed on the CU campus. He told friends at a party he would help the woman get back to her dorm safely, then raped her including with digital and oral penetration.

The work release means he only spends nights at the comfy Boulder County jail - as opposed to a prison - then during the day can leave the jail and pursue college courses or work. Most rapists should have it so good - especially in Colorado - where sexually assaulting an impaired, vulnerable victim can earn the offender up to 20 years to life. (Note: Wilkerson did get 20 years to life on probation).

But for the victim it's been a downward spiral. She hasn't been able to continue her college course work, she's been unable to concentrate, had to get therapy and owes nearly $250,000 in medical expenses and educational  debt. She told the Denver media (including Channel 7 and the Denver Post) she's had to relive the trauma multiple times.

She is still trying to piece her life together, according to a Channel 7 report and must deal every day with panic attacks, depression, and even one suicide attempt. As she's noted: "my life was ruined without my consent".  She added:

"On campus I was on high alert constantly checking over my shoulder. Keep in mind that CU didn’t have a Criminal Protection Order. All CU said was that if we crossed paths, he would have to turn and go the other way. However, this didn’t happen. After the trial conviction, the rapist was in the waiting area. Instead of him turning around and going the other way."

Prosecutors who tried the case were flummoxed when  Judge Patrick Butler delivered the sentence believing it was within the legal parameters and also nothing would be served by passing a maximum penalty.  According to Boulder County DA Lisa Saccomano:

"We’re obviously disappointed by the sentence that was imposed,"

This is especially interesting as Judge Butler evidently harbored his own reservations as when he told the Boulder Daily Camera:

"I do have some great concerns over, as I would describe it as, ways he tried to play the system,"

This was especially galling to many women, specially younger ones, comparing Wilkerson's escape to the Stanford culprit Brock Turner:  - who got off with six months in jail for a felony sexual assault on an unconscious woman.

These light sentences have elicited a discussion  by many women of whether alternative physical punishments should not be advanced in lieu of a stiff prison sentence - as opposed to just giving a light, slap on the wrist sentence. For example, in many Caribbean nations, like Grenada, rapists can accept either a five year sentence or a flogging with 100 lashes delivered. Incredibly, many opt to the prison time, especially after seeing the effects of a bull whip.

Obviously, this  would be seen as too barbaric in the States, but at least one friend - a female physician - has suggested such rapists could be forced to make a choice: prison time or submit to a medical castration procedure (preferably a combination procedure, e.g. physical and chemical).  Thus, they either accept the castration or long prison time - no light escapes.

Her first suggestion was that their prostates be "cryo-ablated" -  basically knife like "needles"  inserted into the gland,  injecting freezing gases to turn it into a small "snowball"  e.g. see the general procedure outlined here: https://www.youtube.com/watch?v=-OnqA-mJDWg

And more detailed here:

 https://www.youtube.com/watch?v=Hoi0872F3Cg

The effect is massive apoptosis or cell death, with lingering effects of impotence and likely incontinence. The therapy is touted as superior to surgery or radiation for prostate cancer treatment but in fact when one does the research the side effects can be just as great.  To ensure the maximal impotence and castration effects on the rapist, she also recommends hormone treatment as a chemical castration. She added, "the bastard will also likely grow breasts and have tender nipples from the hormone which will then have to be treated" - making him more compassionate to the plight of his victim, in her opinion.

If she were a real judge would she pass such a sentence, say on sexual predators like Austin Wilkerson or Brock Turner: "In a New York minute!" she retorted. "Given the hell they unleashed on their victims - both not fully conscious - a little nipple sensitivity and breast enlargement coupled with prolonged impotence is fine."

She makes it clear, however, that the offender doesn't have this forced on him, he has a choice. He can take the prison sentence, OR take the treatment. If the horrors of the prescribed castration are too appalling, there is always the 5 - 20 years or whatever incarceration alternative. Some may argue: "Well, that's no damned choice! Who wants to take 20 years?"  But then they should also ask what choice did these guys offer their victims? It cuts both ways.

Compared to the days when rapists were executed in many states, I'd say they're getting off lightly.

See also:

http://www.dailycamera.com/news/boulder/ci_30232194/boulders-brock-turner-austin-wilkerson-rape-sentencing-outrage

Why Do So Many Men Opt For Castration To Treat Prostate Cancer?

A PET-scan showing extent of bone metastases in a prostate cancer patient. Each dark area represents an agglomeration of actual prostate cancer cells, i.e. in the spine, pelvis, neck etc. If the spread and growth isn't stopped, bones will fracture, spinal discs compress and pain will be constant and excruciating.


Let's concede that once one joins a cancer support group, say for prostate cancer, there is a high probability he will learn about more horrors and fallout from the disease (and its treatments) than he'd normally care to process. Or accept! That also goes for one's wife, who may have to face the consequences of the disease and its treatments along with the patient.

In the support group to which I belong, I recently came across a post by a 68 -year old who bragged he'd added "15 years or so" to his life by resort to an orchiectomy.  On googling the term I learned it meant none other than surgical castration, i.e. the surgical removal of one's testicles leaving the scrotum full of mainly empty space. (Though we are informed "artificial plastic balls can be inserted if the patient desires to give a more natural sensation.")  When I read the guy's post I thought he had lost it: who would rather live life as a half-man, a eunuch basically, just to gain some extra time from prostate cancer? It turns out a lot of guys!

The relevant University of California At San Francisco  (UCSF) document on hormone therapy has billed  the orchiectomy "as the least expensive form of hormone treatment".  It effectively reduces testosterone - the main fuel for prostate cancer- by removing the testes a prime source. Specifically, the effect is almost immediate with testosterone levels plummeting to what is known as "castrate level" within 12 hours.

 The other alternative is chemical castration, which is used when a patient doesn't want to end up physically de-balled,, given it can have "devastating emotional consequences".  (Well, I will say it has to be enormously difficult walking around with an empty ball sack.)  Anyway, in chemical castration one is given one or more medications including casodex, flutamide and finestride.

The medical castration route takes advantage of the chemical-hormone pathways which begin in the hypothalamus with the secretion of luteinizing hormone-releasing hormone  (LHRH) which in turn stimulates the pituitary gland  to produce luteinizing hormone (LH) as well as follicle -stimulating hormone (FSH) . Then LH signals specialized cells in the testicles to secrete testosterone into the bloodstream. When testosterone reaches the prostrate it is converted into di-hydrotestosterone (DHT) a much more potent form of testosterone, via the action of an enzyme:5 -alpha reductase. The objective of medical castration then is to break this cycle, usually in one of two ways: 1) via  LHRH agonists or 2) LHRH antagonists.

In (1) the medication stops the testicles from making testosterone. This is achieved by inducing a continuous message from the brain to produce testosterone which over-stimulates the testes. They respond by being "overworked" so switch off.

In (2) the medication also induces the testes to stop producing testosterone but not by over stimulation (which can trigger a testosterone "flare"(or spike, including uncomfortable side effects) before the level subsides.

The differences between the assorted chemical castration agents and their effects are discussed here for those interested:

https://www.youtube.com/watch?v=KtIfsvQh2qI

In thirty percent or more of these administrations, one of the primary side effects is a condition called gynecomastia which is briefly outlined via one case in this issue of The New England Journal of Medicine. I warn all males, especially those now taking 'high T' supplements or shots, this may well be your future as I will show below!

http://www.nejm.org/doi/full/10.1056/NEJMicm1209166#t=article


Of course, there are sundry other side effects from either surgical or chemical castration, but this one stands out because....well....it's fucking humiliating to be walking around with a pair of man boobs! Also, that they may have to be treated at regular intervals using drugs like tamoxifen or procedures including liposuction (to extract extra glandular tissue) or partial mastectomy.  If you think I am kidding about this, do some googling on your own, starting with the phrase "gynecomastia and prostate cancer" or "gynecomastia and anti-androgen therapy".

The pain and/or sensitivity can be so pronounced that some medical centers which offer castration - surgical and chemical  - say like UCSF, advise patients to get "prophylactic" treatment before commencing hormone treatment. According to a UCSF document:

"This condition arises from a hormone imbalance resulting for a more dominant role for estrogen in a man's body once treatment begins. It occurs more commonly with anti-androgen drugs than with LHRH (luteinizing hormone-releasing hormone )  medications.

We recommend a single dose of radiation to both breasts at the start of treatment."

The dose of radiation is usually 8 Gy delivered by external beam to each nipple. Most guys complain about a "burned" sensation, and needless to say are in no mood for sex afterwards or anyone getting near their nipples or tweaking them. (Of course, the other general side effect of such therapies is to lower libido until when you're shown a Hustler honey in the nude, you have about as much reaction as to an old rocking chair.)

The latest take on hormone treatment is to recommend postponing it until prostate cancer metastases or "mets" appear in the bones. (See e.g.  Paller and Antonarakis: ' Management of Biochemically Recurrent Prostate Cancer After Local Therapy: Evolving Standards of Care and New Directions' ) 

 The reasons for such delay  take into account emergence of  "comorbidities" or hugely negative treatment outcomes, including not only gynecomastia but also a 50 percent higher risk of developing Type II diabetes because the therapy generates weight gain and with it, insulin resistance or metabolic syndrome. You can learn more from this youtube video about the need to treat especially once bone mets appear::

https://www.youtube.com/watch?v=GFHUCnwox7o

It is important to note from this how prostate cancer cells actually grow and develop inside bones and can lead to "skeletal events" that are catastrophic including fractures, and compression of the spinal cord..  The doctor here is referring to radio-pharmaceutical options but this is usually given in late advanced prostate cancer. For early AD treatment, i.e. after "mets" have first appeared, one would go with hormone therapy, anti-androgen therapy etc. See e.g.   https://www.youtube.com/watch?v=0aN0wrjS7_c

And:

https://www.youtube.com/watch?v=PGeFM9ofliA&list=PLu6CZL-_j8BbnvufjBIkBb2TH8f2QbZY4

Given that one absolutely doesn't want to become crippled or saddled with multiple fractures in his last days, i.e. via spread of bone mets, it looks as though I will have to choose some type of hormone therapy. This is assuming my MRI fusion biopsy shows Gleason scores and undifferentiation associated with the lesions detected in the MRI. This would likely not be commenced until bone mets appear, such as on a pet scan, CT-scan or MRI.

This choice would allow at least 10 years,  maybe longer,  for a relative quality of life until the end phase begins with castration resistance, meaning the testosterone plummets but the PSA continues to increase. In other words, hormone treatment ceases to be effective.  As Dr. Charles Ryan points out in the superb UCSF lecture which follows, the prostate cancer cells are capable of making their own testosterone, and hence driving the prostate specific antigens higher.. This "will to survive" marks the challenge of confronting all types of cancer.

To see the detailed UCSF lecture on treating prostate cancer with androgen deprivation and other hormone treatments go to:

https://www.youtube.com/watch?v=kQ4im2WQ75E


See also this basic discussion of how prostate cancer occurs.

https://www.youtube.com/watch?v=7_5MnsdQeQs

I do hope this blog post will be helpful for other guys facing this disease.

How Anthony Weiner's "Weiner" Problem Can Be Solved

Anthony Weiner is back in the news again, and for all the wrong reasons. Though he insists on running for Mayor of New York City, he doesn't appear to have the sound judgment it takes to govern Podunk, Kentucky far less a bustling metropolis with problems and issues of vastly greater magnitude.

One would have thought Weiner would have learned from his earlier instagramming escapades two years ago, but from news accounts he evidently hasn't. Meanwhile, wife Huma has gone out to try and defend her man's honor and his mayoral campaign, to assorted boos and hisses of the pundits.  Personally, I have to more agree with Joe Scarborough on this that Huma's doing it not so much for her randy hubby but for the kids - who are doubtless taking a lot of flack at school, from other kids. For that she merits commendations and kudos not putdowns.

According to one of the recipients of his "erotic messages" interviewed on CBS' Early Show yesterday morning, Weiner admitted to being a "very horny middle-aged man". The young woman gently attempted to disabuse him of such a pejorative, but alas, his subsequent actions, words and instagrams disclosed otherwise, prompting her to tell the interviewer: "Well, he DID turn out to be a very horny middle -aged man!"

Weiner thus seems to be his own worst enemy. But could there be hope for his reconstruction? Say to become a model citizen and model Mayor? Possibly, but it may require an extreme step.

Here's a hint: many men who get prostate cancer have no other choice than to get what is called "hormone treatments" which are really a form of anti-androgen therapy. The treatments can be administered independently and as such resemble the chemical castration sometimes performed on rapists who want to get out of the can sooner, but are more often used as an adjunct to a more intense initial treatment such as radiation therapy or radical prostatectomy.

The advantage of using HT is that the main fuel for prostate cancer, testosterone, immediately dives. The downside, as any prostate cancer patient who's had it can aver, is that one's sex drive absolutely bottoms out to the point you could trot a harem of voluptuous, nude Playboy bunnies into his room and he would barely blink. "Get it on"? Hell, most who receive HT can't get it up even using PDE5 inhibitors (such as Viagra).

Sex then, doesn't even enter the patient's mind. If this is so, then it follows if such a regimen were administered to Weiner, his hyper-drive sex issues would be solved. No more "weinering" and dispatching the results to mid-20s females to convince them of his manhood. Hell, after a few administrations he'd more likely need several,  29-gauge  1/2" needle injections of Bimix in his dick to even half use a sex toy.

What form would it take? Most likely, a hormone therapy using a combination of luteinizing-hormone releasing hormone LHRH or  Leuprolide (marketed as Lupron) and a non-steroidal anti-androgen (Bicalutamide). Within a few days Weiner would notice the difference. By the end of a month, the guy would no longer be hankering to contact young women or astound them by sleazy dick pics. His wife Huma would no longer have to defend her man's aspirations to political office or go to extraordinary lengths to protect her kids.

In a word, Weiner would be basically ready to assume duties as the Mayor of NYC because his "little head"  would no longer be making his decisions for his regular head. Thus, his judgment would no longer be compromised to the extent he can't be trusted in a serious political office.

Further point: to avoid some of the nasty effects (such as enlarged breasts) of such a treatment, it would be done over months then suspended, then resumed again if needed.

Yeah, Weiner's sex life would likely be a casualty - though a surgical penile implant might help for the occasions he needs it for marital relations. But the takeaway is that he's liberated from his overpowering sex drives which continue to humiliate him and his family.

Isn't such a sacrifice worth it?