The media is one of the Five Eyes (Orwell's Nineteen Eighty Four) of the state, or should we say the predatory capitalist elite and their corporate legal entities veiling their legal persons; and feudalism is alive and well expressed in more colour than ever - advertising and marketing, consolidation of power (purchasing of smaller corporations, producing monstrous shady entities like Tencent), incredibly hawkish startups like Fiverr, UbeLyft, Cameo where the company in question barely even does anything; the right wing "think tanks" that sing the hymn of freemarket fundamentalism, the Nobel Peace Prize that Obama absurdly won (Nobel Prize - mentioned in that Living Color song), the odd yet uncontested way that some TV shows put in more right wing guests than left (BBCQT inviting establishment stooges like Kate Andrews (IEA / Adam Smith Institute) and Isabel Oakeshott), the open neofeudal style by which bosses can fire staff and make up a reason without it necessarily being taken to court (the UK govt played with removing funding for wrongful dismissal cases), the initial turning down of the proposed uk law to make homes fit for human habitation (now finally here for 2020); the general trend of corporations shoving all the risk on the consumer and leaning as much as possible on socialized support thanks to the calculating thinkers working for corporations; the fact that truly left-leaning (not liberal) narrative is never referenced on space-age TV, the likes of which span hundreds of potential channels continuously each day; the fact that we are over 50 years into space-age technology and yet everything beyond computer hardware is firmly chokeheld by private interests seeking to impose an alien power over others for personal gain; the fact that everyone is affected by the way that the popular crowd is drawn to celebrity influence (neofeudalism by any other name, and the cult of personality); the fact that jobs are gated by even subtle presumptive aspects like your accent in what we call in the UK the "glass ceiling"; the irresponsible flooding and underinvesting of the job market by governments that can only see as far as their kickback pay packet; the extent to which music and video game media can be financially elevated without legal restraint (unlike gambling which is at least in the formal/technical sense regulated); the attitudes from product pushers being that they should be immune to criticism or shake it off at every turn, under the river of praise from MBTI Sensing-Perceiving types (artwork and memes and mythos mind a la suspense of disbelief rather than logos thought a la conscious self-awareness and critical evaluation) and by "online reputation management"; the open overt acceptance of power being held over everyone by corporate overlords in the movie industry, video game industry and so on - are we to include then the academic and scientific establishments, and the education institution?; the way that the rich siphoning up wealth from the poor divested communities in greater and greater speed ("money is a means to get wealth - not the wealth itself" —Akala) inherently and invariably means they are accruing more power to embarrass the poor when they encounter them and encumber them systemically and indirectly and take on more sex acts with greater choice by selection (the free market); the fact that the powerful go psychologically and sociologically unchallenged by the common people each day; the fact that figures like this "Jeff Bezos makes 2219 dollars in one second which is double what the average person makes in one week. In one minute Mr. Bezos makes 2219x60=133140 dollars. In one hour Mr. Bezos makes 133140x60=7998400 dollars)." go unconsidered and unchecked and unresearched by most; the fact that there are no interactive programming tools to trace, map and prove the linkage between wealth disparity and all social ills; the lack of people like Jaque Fresco in our world (If memory serves right he had a sit down with the power elite, who would have promptly denied him anything truly leftist in vision); the implicit neofeudal psychological programming that IS advertising; the borrowing and corrupting of natural world semantic meanings for selfish neofeudal aims and means; the direct pipeline from education to military and the mandatory military service which still exists in some countries; the fact that returning a product inherently throws the customer (slave) into suspicion by the seller (master - legal power holder); the very idea of a court system ran by the state and not a jury of 3rd party independent people; the lack of a "fairness and welfare supervisor" in every workplace and the presence of "compliance officer"s; the very "free market" in free market fundamentalism which inevitably and invariably defers to which/whoever market force has the most power (today - money - working capital); the fact that being poor and working in a low pay job literally makes you poorer as you work (in real terms); the predatory and inexcusable nature of gambling; the predatory and inexcusable principle of landlords making money off other poorer humans (it should be the state which intervenes if the state is truly a good state, which we can surmise every government is implicitly claiming of itself by holding power); the lack of naming and shaming of social ills like the Nestle CEO who said water access shouldn't be a human right (God I fucking hate Snopes); the trends of people trying to make money off other people via various scams and the likes of BlackHatWorld and WarriorForum, which are innately neofeudalistic in their function, pointing to a giant pyramid scheme that drags along with the rest of modern capitalism; the innate respect given to media moguls and politicians when they are nothing special; the disrespect and disrepute given to the left wing health services of every nation; the blind acceptance of imposing imagery, themes and connotations left dirtying our minds which we call advertisements; the implicit fraud in denying people growing their own food indoors; that concepts like treason do not for most people extend to The People as an interest group; the incredibly rare use of the justification "For the public interest" and "For the public record"; the fact that the French Revolution is not associated for us in school as the birth of the first human rights (surely a non-feudal society would have no qualms or problems with teaching this truth of human history and progress); being frank about racism being too hot for school; the fact kids are now accessing hardcore pornography but not radical and sometimes dangerous ideologies and thinking; the intellectual and spiritual poverty of our age, and the lack of conscious awareness of what we are doing to ourselves with our time and the mental contents surrounding us (a wise man once said.. you will become what you surround yourself with); the mess of the Internet operated by the modern robber-barons of advertising and web traffic conversion and "upselling"; the open betrayal of the people by governments which can be exposed even in form of statistics and hard truths and evidences; the great silence of modern "intellectuals" and losers like self-help gurus (THE MODERN COURT JESTERS), who couldn't begin to address choice quotes of the great intellectual giants of human history; the platforming of celebrities and people with certain types of contours over their face that are pleasing to look at from every angle, over those humans who are better in substance, expertise, spirituality, etc.; the preservation of neofeudal lord roles in the workplace (the boss), the home (the landlord), the Internet (the website owner or advertisers), the land, parks and golf courses (the land holder or owner), and even the family (the wealth-holder parent(s) you are dependent upon); the appeal to authority; the way a poor person under free market fundamentalism must always choose the product most poorly produced i.e. the most likely to break or malfunction and cause them to lose more money, generally kept within reasonable losses or sunk costs as per investment brokers' "portfolios"; the way that moral and ethical wrong cannot by most people be pinned on day traders, Goldman Sachs starving poor people etc. by the inherent flow of the market, which will always favor the most production of immaterial and material wealth by abstraction. (In other words - although we can't fully know and intuit what will be best to produce in any given scenario, we can actually fundamentally and systemically rule out what will be bad and harmful for society - but not for the market which is the concern of free market fundamentalists); the rise of unpaid internships (strongly neofeudal i.e. the local "lord", the company owner, is "giving you an opportunity" and that's how they see it); the propaganda of war producing poor peoples' children dying for the rich few who control the military-industrial complex and massive amounts of money flowing around for rich interests, e.g. soldiers firing missiles that individually cost more than they earn per year, of course ultimately tied up as a capitalistic move/plot/bid to win more cheap oil; the way that companies are literally designed to offer minimal guarantees, insurances or protections for their workers yet they are keen to take with them each working day most of the material gain produced by each worker (remember I said corporations lean on society?); the protection of "limited liability" companies to lose money, versus the individual people who are enslaved by means of debt they cannot easily erase (this bleeds into a general distrust of the independent person compared to the corporate entity, when the people actually are in earnest and wanting to help one another, except for the psychopathic in society who can be known and traced by their behaviour and early signs in school); the fact that healthcare is not free in all countries despite the common people CONSTANTLY working to uphold the corporate masters and the endlessly rich, some of whom donate money to Internet streamers for a laugh at the shock; the mathematical intuitive rational incompetence of the science establishment, which seems to have no backbone when it comes to neofeudalism and major social issues and ills (they don't even speak up against gambling! WHAT THE FUCK IS THE SCIENTIFIC ESTABLISHMENT DOING AND WHY DO WE NOT PUBLICALLY SHAME THEM AS FRAUDULENT PUBLIC INTELLECTUALS - FOR THE PUBLIC INTEREST AND THE PUBLIC GOOD?) and rather, they seem to be the lapdogs of the elite, continuing to produce inventions which can easily be taken advantage of by the right wing interests - tear gas and rubber bullets for example; the lack of public awareness of state interference in a negative way; the arrival of private police forces; the hierarchy of control of the Internet based on what they call "authority sites" - prioritized by search engines. (I apologize for the formatting but this was a train of thought.)
Dr. Ronald Weiss: Chronic post-vasectomy pain syndrome is exceedingly rare.
Dr. Ronald Weiss: Aug 25, 2002 Re: Painful reminder, Aug. 19. This article is incomplete and misleading. Chronic post-vasectomy pain syndrome is exceedingly rare. According to Dr. Marc Goldstein, the foremost authority on vasectomy in the world, it's likely closer to 1 in 10,000 or one one-hundredth of one per cent, rather than the one to five per cent of men quoted in the article. It is not unusual to experience some discomfort following vasectomy, or any other surgery for that matter, but this short-lived pain does not constitute post-vasectomy pain syndrome. Your readers should not be led to believe that if they experience some discomfort following their procedure, that they will be saddled with this distressing condition forever. Discomfort following vasectomy is a function of many things, including the experience of the surgeon (the more vasectomies the surgeon does, the less likely the complications); the technique (no-scalpel versus conventional, open-ended versus closed-ended); and the experience of pain during the procedure (better anesthesia increases the likelihood of a better outcome). None of this was mentioned in the article. Chronic post-vasectomy pain syndrome is a well-recognized condition in the medical community and, rare as it is, forms part of all informed consents for this procedure. Dr. Ronald S. Weiss, Ottawa, assistant professor, University of Ottawa medical school Editor's note: Dr. Weiss, a family doctor, has performed more than 10,000 vasectomies. https://imgur.com/gallery/nJkGG3B Statement Score: ★★★☆☆ -- Mentions chronic pain risk but gives incorrect statistics
This article is incomplete and misleading. Chronic post-vasectomy pain syndrome is exceedingly rare. According to Dr. Marc Goldstein, the foremost authority on vasectomy in the world, it's likely closer to 1 in 10,000 or one one-hundredth of one per cent, rather than the one to five per cent of men quoted in the article.
Here are the chances for chronic pain caused by vasectomy given by several national level health organizations. These are the professional societies and experts that the urologists are supposed to be getting their statistics from:
Canadian Urology Association give the chronic pain outcomes for vasectomy at between 1-14%(Link)
American Urological Association says chronic pain serious enough to impact quality of life occurs after 1-2% of vasectomies. (Link)
British Association of Urological Surgeons, patient advice reports troublesome chronic testicular pain which can be severe enough to affect day-to-day activities in 5-14% of vasectomy patients. (Link)
UK National Health Service says long-term testicular pain affects around 10% of men after vasectomy. (Link)
11th edition of Campbell Walsh Urology (2015) cites 10% incidence of chronic scrotal pain caused by vasectomy. (Link)
European Association of Urology (2012) cites 1-14% incidence of chronic scrotal pain caused by vasectomy, usually mild but sometimes requiring pain management or surgery (Link)
Royal College of Surgeons of England says significant chronic orchalgia may occur in up to 15% of men after vasectomy, and may require epididymectomy or vasectomy reversal. (Link)
Journal of Andrology cites large studies that find Post Vasectomy Pain Syndrome 2-6% of the time (Link)
UpToDate says "surveys have found that the incidence of "troublesome" post-vasectomy pain is reported by approximately 15% of men, with pain severe enough to affect quality of life in 2%. However, survey respondents may not have been representative of all men who have had a vasectomy." (Link)
European Association of Urology says Post-vasectomy scrotal pain syndrome is a scrotal pain syndrome that follows vasectomy. Post-vasectomy scrotal pain syndrome is often associated with negative cognitive, behavioural, sexual or emotional consequences, as well as with symptoms suggestive of lower urinary tract and sexual dysfunction. Post-vasectomy pain may be as frequent as 1% following vasectomy, possibly more frequent.(Link)
German Federal Center for Health Education says "The information on how many men seek medical treatment because of this fluctuates between one and 14 percent." (Link)
American Family Physician says "Recent studies estimate the incidence of severe postvasectomy pain syndrome to be between 1% and 6%" (Link)
International Journal of Environmental Research and Public Health published a meta-analysis in March 2020 to determine the incidence of PVPS, which examined 559 peer-reviewed studies and concluded that "Post-vasectomy pain syndrome occurred in 5% of subjects" (Link) The authors determined that "the overall incidence of post-vasectomy pain is greater than previously reported."
StatPearls says "about 1% to 2% of all men who undergo vasectomies will develop constant or intermittent testicular pain lasting greater than 3 months which is then defined as post-vasectomy pain syndrome." (Link)
According to Dr. Marc Goldstein, the foremost authority on vasectomy in the world, it's likely closer to 1 in 10,000 or one one-hundredth of one per cent
I wasn't able to find an instance of Dr. Goldstein claiming that the rate of PVPS is 1 in 10,000 but here is an example of Dr. Goldstein claiming that the rate of PVPS is 1 in 1,000:
Several possible long-term effects associated with vasectomy include chronic testiculaepididymal pain, testicular dysfunction, vasitis nodosa, and chronic epididymal obstruction. Approximately 1 in 1000 men will experience chronic testiculaepididymal pain postoperatively. Possible treatments for this bothersome complication include vasectomy reversal, open-ended vasectomy, or even total epididymovasectomy.
https://pubmed.ncbi.nlm.nih.gov/16806411/ via (https://www.maleinfertility.org/sites/default/files/general/vasectomy_packet.pdf ) What do Dr. Weiss' patients have to say? I had my vasectomy done by Dr. Ronald Weiss in Ottawa last year. Still in severe pain and taking numerous nerve drugs daily. I was told by him that the risk was 1 in 10,000 risk of a chronic ache in the testicle for which a reversal is required. I read stuff on the internet beforehand, and here beforehand, and I honestly thought that some guys were exaggerating their pain and it must be really rare. I also thought ‘a doctor can’t lie about risks of surgery, with liability reasons and all.’ Well, I guess my suffering from PVPS is karma for not believing all the guys on here suffering. https://www.postvasectomypain.org/t/are-you-a-pvps-victim-of-dr-ronald-weiss-in-ottawa-ontario/1777 I am experiencing PVPS. Dr. Weiss was very efficient. The procedure was also very efficient. His staff was also very efficient. That is where it ends. If you are lucky to have no complications after the surgery then consider yourself lucky. If you do have complications, and the risk is higher than you are led to believe, then don't bother calling Dr. Weiss. Once you are through his assembly-line procedure he is done with you. He has zero compassion. He has zero bedside manner. He will tell you to your face "It's not my fault" and spout off statistics like "I've done this 55,000 times" What doctor keeps stats like this? If you are considering a vasectomy, my advice is DON'T. It is not worth the high risk of pain that may plague you for the rest of your life. https://www.ratemds.com/doctor-ratings/98740/Dr-Ronald-Weiss-Ottawa-ON.html Having chronic pain 3 months after the procedure... Seems to be granuloma. His nurse told me rest and anti inflammatory meds or a few days until it subsided.. after reading numerous forums on post vasectomy pain, I’m becoming increasingly concerned with the outcome... a recent 4-wheeler ride has made me have some sharp pain and inflammation. I would NOT reccomend the procedure or doctor at this point... Do not alter your body. The stats you are given are NOT accurate and you are at more of a risk than you realize. https://www.ratemds.com/doctor-ratings/98740/Dr-Ronald-Weiss-Ottawa-ON.html DON'T DO IT I've learned a few things since this regrettable decision I made. First and foremost is that nature is not to be f'd with - altering your natural body is not a good idea if it can be avoided. The other things I've been learning is how ill-informed us guys are about the consequences of having a vasectomy and all the things that can go wrong. "you'll be fine" they all said, "a couple days" they kept saying, "it can't be any worse than giving birth" - ya F that. Giving birth is the most natural part of living and a woman gets the gift of a child from it. Altering your insides is not natural at all and it has given me nothing but terrible pain and that sick nauseous feeling you get when kicked in the balls HARD - CONSTANTLY each and every day for 7 weeks now. I am so f'ing sick of icing my balls each and every f'ing day but it is the only thing that helps. I've now had the shits on top of all the other discomfort from being on meds for so long. I'm not even sure that the pills are helping but I take them and put up with the diarrhea because I am willing to do whatever it takes to try and get through this and get back to normal. I cannot put into words how badly I wish I could have a do-over and listen to my gut that was telling me over and over again not to do it. I did it for my wife and now I hate my f'ing life. I've contemplated suicide more times than I care to admit because I do not want to live like this. I was a f'ing stallion in bed before and I haven't been able to be who I was before with my wife ever since. The only sex I can handle now is very lame, lazy, and stupid careful so that I don't bring on the crazy pain I've experienced the few times I attempted to become even half the man I was before. Release has moved from a desire to a necessity because the pain increases substantially when my balls are full - not cool. Epididymitis I believe is what I am suffering from, although I don't know that for sure because when I went back for an exam I was told in about 5 minutes that I just need to give it more time and more drugs. This has affected my quality of life in a way I never imagined. I've given up exercise (and I am very active), I can't lift anything heavy anymore, it pains me to lift my children, I begin and end every day with ice on my nuts, I'm dealing with the effects of the nonstop ingestion of drugs, I'm in pain and discomfort constantly 24/7, and my sex-life has suffered terribly. Ball pain has become the new norm for me so now it just depends on the level I'm feeling that day whether I say I'm good or not - I'm never feeling great anymore, some days are just better than others - some are brutal. Guys are not informed enough about this so this is my attempt to remedy this. I wish I could go back in time but I can't. Instead I just have to hope and pray that this eventually goes away, though it doesn't feel like that is ever going to happen. Don't gamble on permanent ball pain guys, it is the absolute worst. I try not to blame my wife for the pressure she put on me to have this done but I curse her often.. some days I snap because I'm just so tired of feeling this way. I've yelled at people at work, I've been a grown man crying on my couch, I've thought about ending it - only reason I will put up with it is because of my 2 beautiful boys who I could never abandon no matter how much I hurt... just cannot describe how much I regret this decision. Sure most guys say they are fine but it's not guaranteed. If you feel pressured by any woman to have this done my advice is to tell them to go F themselves. There are other alternatives to contraception that avoid any chance of these terrible outcomes and they should be the go to. This practice should be banned in my opinion. All I can do is pray that this pain goes away. Worst decision of my life by far. Don't do it. https://www.ratemds.com/doctor-ratings/98740/Dr-Ronald-Weiss-Ottawa-ON.html?page=2 My husband seen Dr. Weiss in April. We are now the end of August and he is still in pain. This isn’t normal. He went to a walk in clinic and they gave him inflammatories and told him to call doctor Weiss on the Monday. Monday morning comes, he calls and the secretary tells him she will prescribe him inflammatories and for him to come in a week later. Of course my husband got frustrated, he’s in pain, missing work because of this and this secretary plays him for a fool. He finally went in this morning and the doctor prescribed him inflammatories and tells him to call his family doctor as he was rude on the phone with the secretary and doesn’t want to see him in the office anymore. Seriously!!!!!! Just get your money and don’t deal with your patients problem afterwards. Way to do business. He’s been in pain for 4 months, shame on you and your coworker. You need to stop your practice because you aren’t very good at it and do not take responsibility. https://www.ratemds.com/doctor-ratings/98740/Dr-Ronald-Weiss-Ottawa-ON.html?page=2 I had a V in 2006, procedure itself went fairly smooth however my life has never been the same. I called the office a day or so after the procedure explaining the pain I was in but my plea for help was dismissed and I was told it was "normal". I made an apt with Dr Weiss shortly after the V and told him the about the pain I was suffering. He simply didn't give a sh*t and even had the nerve to say "its not from anything I did". I saw a Urologist about a year after the V and he said to try and wait it out, the pain may just go away. Slowly, month by month, year by year, the pain did get better however I was far from 100%. Around year 4 I felt a sudden twinge in my testicles and it has been complete nightmare since. I'm now entertaining the V-reversal idea, I've seen countless Dr's, Urologists, Surgeons, Gp's seeking help but nobody seems to know what to do. I would strongly advise anyone out there NOT TO GET A VASECTOMY! The 1in10,000 odds are simply lies. Having the V was easily the worst decision of my life, I'll never be whole again. I sincerely don't want to continue living in this condition, if I was a family pet, my owners would have put me down long ago. I was duped by this man, the numbers speak for themselves. POST VASECTOMY PAIN IS A REALITY. https://www.ratemds.com/doctor-ratings/98740/Dr-Ronald-Weiss-Ottawa-ON.html?page=3 I had a vasectomy done by Dr. Weiss in 2009, and am still dealing with the aftermath. I had sometimes severe post-vasectomy pain for fourteen months following the procedure. Dr. Weiss initially told me the pain would just go away, and then when it didn't, became angry with me and told me the only treatment was a reversal. I wrote him a letter in an effort to improve his practice, but he again blew me off. It is eight years later, and I now have cysts and debris in my scrotum. I have had to see urologists about the complications. Dr. Weiss has the worst bedside manner of any specialist I have ever seen in Ottawa. He should not be performing a procedure the consequences of which he does not seem to understand. https://www.ratemds.com/doctor-ratings/98740/Dr-Ronald-Weiss-Ottawa-ON.html?page=3 2 months later my balls still hurts, it ruins my life. No more sport, constant pain, to come back, never have done it!!! https://www.ratemds.com/doctor-ratings/98740/Dr-Ronald-Weiss-Ottawa-ON.html?page=3 Me too on the pain. Also have found out that the rates given were not true. I tried to report him to the urologists Ontario group but he is not a urologist. He is a family doctor. That's seems the next step. Anyone tried to sue for the misinformation and pain? https://www.ratemds.com/doctor-ratings/98740/Dr-Ronald-Weiss-Ottawa-ON.html?page=4 Dr. Weiss botched my husband's vasectomy and left him in constant agony. He went from being a great dad and sweet husband to a pill popping couch potato overnight. Dr. Weiss' staff said wear the support and take the naproxen. It's been nine months now and my husband is getting worse - I don't know how we will make ends meet, we never, in our wildest dreams expected him to become incapacitated from this 'safe and simple procedure.' I have come to find out through various medical channels that my husband's post vasectomy pain is more common than Dr. Weiss let on. It's actually more like 2%, so 1 in 50, not 1 in 10,000. I can't believe how many 'victims' of Dr. Weiss are on this site alone. It's mind-boggling. You misled us Dr. Weiss and now our lives are ruined. You stole my husband from me and you stole my children's father from them. You should be ashamed of yourself, you greedy lying swine. https://www.ratemds.com/doctor-ratings/98740/Dr-Ronald-Weiss-Ottawa-ON.html?page=4 Amateur Hack! Don't go. This guy aint even a urologist! He's just a family doc not a friggin surgeon. When the kicked in the balls pain that I have never went away and I went to see him about it, he had no idea what to do and acts like he's never even seen this crap before! Then I start researching (shoulda done that before) and find out that anywhere from 1-5% will have severe scrotal pain and it cant be fixed! WTF!! I fell like Im being kicked in the nuts all day every day - I cant sleep I cant eat I cant work and its been almost a year now! Im ready to hack my nuts off with a garden shear, but will that make it worse? Thanks Ronnie you lying scumbag...1 in 10,000 my a.s.s. more like 1 in 20 https://www.ratemds.com/doctor-ratings/98740/Dr-Ronald-Weiss-Ottawa-ON.html?page=4 I can't believe I have PVPS. I cant believe this doc lied to me. My life is a living nightmare and I am now disabled. My current urologist who is trying to fix my PVP/s (without much success) has told me that there are numerous postal surveys and studies done which show PVP to be anywhere from 1-2% or 5-10% depending upon source. He admits it's a serious problem and that vasectomists all over the place lie about the risks. Dr. Weiss told me it was 1 in 10,000 chance of a chronic ache and that a reversal would fix it - couldn't be more untrue. I can't sleep, i can't exercise, I take pain meds all day and cant work as my job requires heavy lifting. Dont go. I wish I could take back that fateful day. https://www.ratemds.com/doctor-ratings/98740/Dr-Ronald-Weiss-Ottawa-ON.html?page=4 Count me in as another unlucky PVPS sufferer. If it was really 1 in 10,000 as Dr. Weiss stated, then why are there so many of us on here? Also check this out: https://www.auanet.org/common/pdf/education/clinical-guidance/Vasectomy.pdf It's the American Urological Association's guidelines on vasectomy, wherein they state a 1-2% chance of chronic scrotal pain severe enough to impact quality of life, with a bunch of peer reviewers, including, none other than Dr. Ronald Weiss himself! So he peer reviewed AUA guidelines and agreed with the 1-2% severe pain figure, yet prefers to say the chance is actually .01%? Unbelievable. Oh BTW, a reversal failed to fix my pain, and it's suspected that the perineal branch of my pudendal nerve (which is in your scrotum) was hit by Dr. Weiss during my vasectomy. No wonder why I not only have stabbing, tingling, burning scrotal pain, but also anal pain and severe pain when sitting. I was perfectly healthy before and now life sucks. I'm middle aged and don't want to live another 20-30 years like this. No way. There's nothing to be done that can fully bring you back to the way you were. Look it up online, it's all over the place, numerous studies have been published for decades. I've never seen such lies about a medical procedure before, never in my entire life. Don't do it, just use condoms, sure they suck, but at least you won't end up with pain in your junk for your whole life. https://www.ratemds.com/doctor-ratings/98740/Dr-Ronald-Weiss-Ottawa-ON.html?page=5 Dr. Weiss should be sued for misleading his patients into believing that the rate of Post-Vasectomy complications, also known as Post-Vasectomy-Pain-Syndrome (PVPS), is lower than it actually is. His brochure misstates the rate of this life-crippling condition. Whether he is too busy making $ to update his brochure with actual research findings or whether he is purposely misleading his clientele, matters little. He is uncaring and more worried about his reputation than his patients. Surveys in recent years have found that almost 15% of men suffer from PVPS, with 2% of men experiencing pain intense enough to impact their quality of life. One review reported that 1 in 1000 men who undergo a vasectomy will sustain long-term pain requiring surgical intervention. So his brochure is absolutely bogus. Do not believe a word he tells you--reconsider your options. Dr. Weiss has been dismissive of chronic pain resulting form his surgery for years. His solution is to ignore or write prescriptions in doses that even raises the pharmacists' eyebrows. I think the worst problem is that in order to guard his obviously frail reputation, he refuses to write referrals to see REAL urologists that can actually help try remedy the problem. Do yourself a BIG favour and research the risks associated with PVPS. Yes, all surgeries have risks, but if someone told you you have 1-3 chances in ten to be in debilitating pain for months, years, and possibly the rest of your life, would you make the same decision? Please think twice and see another doctor that isn't just interested in money. He is the WORST choice you will make in your life. https://www.ratemds.com/doctor-ratings/98740/Dr-Ronald-Weiss-Ottawa-ON.html?page=5
In Jesuit controlled China, there is a market that facilitates the open sale of children for money
In Jesuit controlled China, trafficking of children is a huge problem but there is a market where children are actually sold for money:
For sale: Chinese babies and children HONG KONG — No nightmare is more chilling than having one’s child stolen away. But in China, that nightmare becomes real up to 70,000 times a year. Although little known about it outside the country, child trafficking is epidemic in the People’s Republic. Every year, thousands of young children — typically from poor families — are kidnapped, transported hundreds of miles, and sold for $500 to $5000. Some end up as prostitutes or slave laborers. Most are bought by people who want to raise the child as their own. Stymied by poverty and indifferent local police, many birth parents hunt for their children for years and never find them. Beijing has been trying to combat the problem for years. Police have rescued more than 54,000 children and cracked down on 11,000 traffickers since 2009, according to Xinhua news agency. China does not release statistics on the overall number of abduction cases reported. “Estimates range from about 10,000 to 70,000 kids per year,” says Charlie Custer, the co-creator of a new documentary on the subject, Living With Dead Hearts. “You can't put that many kids on a milk carton.” Official cooperation on the matter has been mixed. At a hearing in late September, the UN Committee on the Rights of the Child asked a Chinese delegation whether Beijing would ban all forms of trafficking and sale of children. The delegation declined to answer. The committee also urged the government to enlist more help from civil society in rooting out trafficking. Yet China is taking steps toward tackling the problem. The government has created an anti-abduction task force that investigates and cracks down on baby smuggling rings. This month, the group freed 92 children who had been stolen from poor regions of southwestern Sichuan and Yunnan provinces. But for families, such measures are not enough. Many say that local police offer little help to parents filing abduction reports. When the police do act, it’s often too late. The first few days after a kidnapping are crucial, as organized crime rings can quickly transport children thousands of miles through a network of accomplices. In fact, in some areas, the government is complicit. Earlier this year, a family planning official in Fujian province was arrested for helping broker the sale of four babies. Some officials have also helped falsify papers to put children in orphanages, where they can be adopted by international clients who must pay steep fees. According to a 2011 investigation by Caixin magazine, some of these children have ended up in the US, Poland, and other Western countries. “I would just say, don't adopt a kid from China now,” Custer says. Why is this happening? Many experts point blame at the one-child policy. Parents who want a son may decide to buy one on the black market, to avoid the risk of giving birth to a daughter and paying fines. One recent case involved a family with three daughters in Henan province who paid over $8,000 for an infant boy. There are social factors as well. People who purchase abducted children face little or no penalty, as long as the youths are treated decently. And a long tradition in China of people raising distant relatives’ children as their own gives buyers some cover. “More broadly, the problem is as big as it is because China has this culture of, don't get involved in anyone else's business,” Custer says. “A lot of these kids who are kidnapped, are taken in places where there are people around. But people don't say anything.” Most importantly, child trafficking is a profitable business. Even doctors, who are paid relatively little in China, can be tempted to join the trade. In August, an obstetrician in Shaanxi province was arrested for selling newborns for $2,500. She deceived parents by telling them that their babies were too sick to survive after delivery. She had carried on this way for seven years, and was only caught after a distraught father climbed onto the roof of his house and threatened to jump if police did not investigate. Critics are calling for China to penalize buyers of stolen children. Yu Jincui, an editor at the Global Times, wrote that China must punish parents who buy stolen children, thereby “curbing supply as well as demand.” “Both traffickers and buyers must realize there is a heavy penalty for their actions.”
Another article on Quartz:
Child trafficking in China often starts with parents selling their own kids In China, anywhere from 20,000 to 200,000 children are abducted every year, either sent into forced labor or sold to quasi-legal adoption brokers. While many of these children were taken away by strangers in public places, public court documents from China indicate that child traffickers often have a willing accomplice—the child’s biological parents. A reporter from China’s Southern Metropolis Daily studied court documents (link in Chinese) from 364 cases involving a total of 380 abducted children and 508 suspects. In 40 percent of the cases, the child’s biological parents sold their own children to other people, who sometimes went on to traffic them. According to the study, the most common cause of child trafficking is China’s one-child policy. Implemented in 1980 and partially relaxed in 2013, the law imposes fines on families who give birth to two or more children. Families ill equipped to pay penalties on top of the costs of raising a child—food, school tuition, etc.— sometimes opt to sell their offspring. But for others parents, trafficking their children is a source of cash. Southern Metropolis Daily cites one case where a Hunan couple initially sold their second child for 6,000 yuan (about $1,000), out of economic necessity. But after the first time, they continued to conceive, and sold their third and fourth child for 20,000 yuan (about $3,000) and 10,000 respectively. The court ultimately sentenced the father to six years in jail and fined him 20,000 yuan. Other unfortunate circumstances can lead to parents willfully traffic their own children—the report cites anecdotes involving gambling debts, divorces, and deceptive spouses. The court cases also reveal more about China’s marketplace for trafficked children. Of the 380 trafficked children from the court cases, 248 were male and 120 were female. Daughters tend to sell for an average of 10,000 yuan, while sons go for much more—an average of 45,000 yuan. The study examines just a fraction of the total number of estimated kidnappings annually, so it is possible that this 40% number is too high, or too low. The study also only looks at incidents that have made it to Chinese courts. Human rights and human trafficking experts in China told Quartz that the 40% figure wasn’t implausible. “There definitely are parents – a lot of parents – who sell their kids to traffickers,” says Charlie Custer, director of the 2013 documentary Living With Dead Hearts. Parents who are publicly searching for their missing kids probably didn’t sell them, he said, because these searches can cost more than what a child would be worth to traffickers. “The ones selling their kids will often be trying to hide that they had a kid in the first place – when they discover they’re having a kid, they’ll go home to the countryside and lay low with some family so most of their social circle isn’t aware they even gave birth.”
An article on inkstone:
A Chinese baby for sale for $9,000 on social media For sale: a healthy baby boy. Six people have been arrested in central China after claims that a newborn baby boy was offered for sale on social media for 60,000 yuan ($9,200), according to a police statement. An investigative report by the Xiaoxiang Morning Post was the first to point the finger at a group based in the city of Yiyang, Hunan province, which it accused of running a human trafficking operation via the popular messaging platform WeChat. According to the newspaper article, the group posted a message in mid-June that offered “a newborn, healthy boy” for sale. Anyone interested in buying him should “please come to Hunan, Yiyang quickly.” The post was accompanied by two videos of an infant and alleged information about his parents, who “felt unable to raise a second child,” the report said. The police statement said: “Multiple media outlets and an unnamed individual reported that infants were being trafficked from a hospital in Yiyang on June 21, and the department arrested three suspects at the scene.” A subsequent inquiry led police to other suspects, it said. “After the establishment of an investigative panel … we arrested three further suspects. So far, there are six people [in custody] and the case remains under investigation.” The newspaper report claimed that the traffickers contacted pregnant women when they arrived at the hospital and were often able to find buyers for their babies within two to three days. Some of the gang members had contacts at multiple hospitals across the city, it alleged. Child trafficking is a persistent problem in China. Children abandoned or abducted from poor regions are often taken to affluent coastal cities. Some are sold to couples who cannot have children of their own, while many others go to families that want a son but are bound by the country's family planning policies. Traffickers usually charge more for baby boys. As for the baby boy put up for sale, his birth mother was asked to sign a declaration saying, “I give up my infant voluntarily [and] for free. I hope you [the adopted parents] can treat him with kindness.” The newborn’s current whereabouts are unknown.
The media is one of the Five Eyes (Orwell's Nineteen Eighty Four) of the state, or should we say the predatory capitalist elite and their corporate legal entities veiling their legal persons; and feudalism is alive and well expressed in more colour than ever - advertising and marketing, consolidation of power (purchasing of smaller corporations, producing monstrous shady entities like Tencent), incredibly hawkish startups like Fiverr, UbeLyft, Cameo where the company in question barely even does anything; the right wing "think tanks" that sing the hymn of freemarket fundamentalism, the Nobel Peace Prize that Obama absurdly won (Nobel Prize - mentioned in that Living Color song), the odd yet uncontested way that some TV shows put in more right wing guests than left (BBCQT inviting establishment stooges like Kate Andrews (IEA / Adam Smith Institute) and Isabel Oakeshott), the open neofeudal style by which bosses can fire staff and make up a reason without it necessarily being taken to court (the UK govt played with removing funding for wrongful dismissal cases), the initial turning down of the proposed uk law to make homes fit for human habitation (now finally here for 2020); the general trend of corporations shoving all the risk on the consumer and leaning as much as possible on socialized support thanks to the calculating thinkers working for corporations; the fact that truly left-leaning (not liberal) narrative is never referenced on space-age TV, the likes of which span hundreds of potential channels continuously each day; the fact that we are over 50 years into space-age technology and yet everything beyond computer hardware is firmly chokeheld by private interests seeking to impose an alien power over others for personal gain; the fact that everyone is affected by the way that the popular crowd is drawn to celebrity influence (neofeudalism by any other name, and the cult of personality); the fact that jobs are gated by even subtle presumptive aspects like your accent in what we call in the UK the "glass ceiling"; the irresponsible flooding and underinvesting of the job market by governments that can only see as far as their kickback pay packet; the extent to which music and video game media can be financially elevated without legal restraint (unlike gambling which is at least in the formal/technical sense regulated); the attitudes from product pushers being that they should be immune to criticism or shake it off at every turn, under the river of praise from MBTI Sensing-Perceiving types (artwork and memes and mythos mind a la suspense of disbelief rather than logos thought a la conscious self-awareness and critical evaluation) and by "online reputation management"; the open overt acceptance of power being held over everyone by corporate overlords in the movie industry, video game industry and so on - are we to include then the academic and scientific establishments, and the education institution?; the way that the rich siphoning up wealth from the poor divested communities in greater and greater speed ("money is a means to get wealth - not the wealth itself" —Akala) inherently and invariably means they are accruing more power to embarrass the poor when they encounter them and encumber them systemically and indirectly and take on more sex acts with greater choice by selection (the free market); the fact that the powerful go psychologically and sociologically unchallenged by the common people each day; the fact that figures like this "Jeff Bezos makes 2219 dollars in one second which is double what the average person makes in one week. In one minute Mr. Bezos makes 2219x60=133140 dollars. In one hour Mr. Bezos makes 133140x60=7998400 dollars)." go unconsidered and unchecked and unresearched by most; the fact that there are no interactive programming tools to trace, map and prove the linkage between wealth disparity and all social ills; the lack of people like Jaque Fresco in our world (If memory serves right he had a sit down with the power elite, who would have promptly denied him anything truly leftist in vision); the implicit neofeudal psychological programming that IS advertising; the borrowing and corrupting of natural world semantic meanings for selfish neofeudal aims and means; the direct pipeline from education to military and the mandatory military service which still exists in some countries; the fact that returning a product inherently throws the customer (slave) into suspicion by the seller (master - legal power holder); the very idea of a court system ran by the state and not a jury of 3rd party independent people; the lack of a "fairness and welfare supervisor" in every workplace and the presence of "compliance officer"s; the very "free market" in free market fundamentalism which inevitably and invariably defers to which/whoever market force has the most power (today - money - working capital); the fact that being poor and working in a low pay job literally makes you poorer as you work (in real terms); the predatory and inexcusable nature of gambling; the predatory and inexcusable principle of landlords making money off other poorer humans (it should be the state which intervenes if the state is truly a good state, which we can surmise every government is implicitly claiming of itself by holding power); the lack of naming and shaming of social ills like the Nestle CEO who said water access shouldn't be a human right (God I fucking hate Snopes); the trends of people trying to make money off other people via various scams and the likes of BlackHatWorld and WarriorForum, which are innately neofeudalistic in their function, pointing to a giant pyramid scheme that drags along with the rest of modern capitalism; the innate respect given to media moguls and politicians when they are nothing special; the disrespect and disrepute given to the left wing health services of every nation; the blind acceptance of imposing imagery, themes and connotations left dirtying our minds which we call advertisements; the implicit fraud in denying people growing their own food indoors; that concepts like treason do not for most people extend to The People as an interest group; the incredibly rare use of the justification "For the public interest" and "For the public record"; the fact that the French Revolution is not associated for us in school as the birth of the first human rights (surely a non-feudal society would have no qualms or problems with teaching this truth of human history and progress); being frank about racism being too hot for school; the fact kids are now accessing hardcore pornography but not radical and sometimes dangerous ideologies and thinking; the intellectual and spiritual poverty of our age, and the lack of conscious awareness of what we are doing to ourselves with our time and the mental contents surrounding us (a wise man once said.. you will become what you surround yourself with); the mess of the Internet operated by the modern robber-barons of advertising and web traffic conversion and "upselling"; the open betrayal of the people by governments which can be exposed even in form of statistics and hard truths and evidences; the great silence of modern "intellectuals" and losers like self-help gurus (THE MODERN COURT JESTERS), who couldn't begin to address choice quotes of the great intellectual giants of human history; the platforming of celebrities and people with certain types of contours over their face that are pleasing to look at from every angle, over those humans who are better in substance, expertise, spirituality, etc.; the preservation of neofeudal lord roles in the workplace (the boss), the home (the landlord), the Internet (the website owner or advertisers), the land, parks and golf courses (the land holder or owner), and even the family (the wealth-holder parent(s) you are dependent upon); the appeal to authority; the way a poor person under free market fundamentalism must always choose the product most poorly produced i.e. the most likely to break or malfunction and cause them to lose more money, generally kept within reasonable losses or sunk costs as per investment brokers' "portfolios"; the way that moral and ethical wrong cannot by most people be pinned on day traders, Goldman Sachs starving poor people etc. by the inherent flow of the market, which will always favor the most production of immaterial and material wealth by abstraction. (In other words - although we can't fully know and intuit what will be best to produce in any given scenario, we can actually fundamentally and systemically rule out what will be bad and harmful for society - but not for the market which is the concern of free market fundamentalists); the rise of unpaid internships (strongly neofeudal i.e. the local "lord", the company owner, is "giving you an opportunity" and that's how they see it); the propaganda of war producing poor peoples' children dying for the rich few who control the military-industrial complex and massive amounts of money flowing around for rich interests, e.g. soldiers firing missiles that individually cost more than they earn per year, of course ultimately tied up as a capitalistic move/plot/bid to win more cheap oil; the way that companies are literally designed to offer minimal guarantees, insurances or protections for their workers yet they are keen to take with them each working day most of the material gain produced by each worker (remember I said corporations lean on society?); the protection of "limited liability" companies to lose money, versus the individual people who are enslaved by means of debt they cannot easily erase (this bleeds into a general distrust of the independent person compared to the corporate entity, when the people actually are in earnest and wanting to help one another, except for the psychopathic in society who can be known and traced by their behaviour and early signs in school); the fact that healthcare is not free in all countries despite the common people CONSTANTLY working to uphold the corporate masters and the endlessly rich, some of whom donate money to Internet streamers for a laugh at the shock; the mathematical intuitive rational incompetence of the science establishment, which seems to have no backbone when it comes to neofeudalism and major social issues and ills (they don't even speak up against gambling! WHAT THE FUCK IS THE SCIENTIFIC ESTABLISHMENT DOING AND WHY DO WE NOT PUBLICALLY SHAME THEM AS FRAUDULENT PUBLIC INTELLECTUALS - FOR THE PUBLIC INTEREST AND THE PUBLIC GOOD?) and rather, they seem to be the lapdogs of the elite, continuing to produce inventions which can easily be taken advantage of by the right wing interests - tear gas and rubber bullets for example; the lack of public awareness of state interference in a negative way; the arrival of private police forces; the hierarchy of control of the Internet based on what they call "authority sites" - prioritized by search engines. (I apologize for the formatting but this was a train of thought.)
Newcastle Upon Tyne, Newcastle University Drop-Out, Collaborated With Blockchain Giants to Bring Online Gambling on a Decentralized Platform
Global,Newcastle University drop-out withdrew from his course in January 2014 to explore different industries and sectors worldwide. After facing trust issues in different business sectors, experiencing massive depths and losses. He indulged with blockchain technology and researched the colossal potential of decentralized applications. His inspiration was his mentor, Mr.Graham Morgan, at Newcastle University and another technology-based entity, BLOCKCHAIN. Amber Kumar, who was pursuing Msc in computer game engineering, experienced an epiphany about the ongoing healthcare, travel, gambling, and financeindustry's major problem. Knowing the benefit of blockchain technology and how effective it is for the world, a system way too autonomous and decentralized maintains transparency in records, be it transactional, asset, identity, as needed. When asked to justify blockchain's transparency- He said, "It gives assured control over data and privacy as it makes use of smart contracts that are not prone to human interference, thus preventing cybercrime, hacking, password leaks, and data thefts." 2014, the year when he started researching blockchain technology and eventually formed WSCF Global. Next, his profound thoughts led to the amalgamation of blockchain and online gaming resulting in Supraorbs. 'The secret of getting ahead is getting started' (Mark Twain). Indeed Amber is on his way to growth and success, for he took his journey with blockchain technology ahead. WSCF Global, with the collaboration of US partners and Russian partners (who have 12 years of experience in the finance industry), boosted the cryptocurrency market. DHF (Decentralized Hedge Fund) was the product of their collaboration, giving its users an average of 10% per month. It is an independent platform that is run by AI programmed for financial management and growth. It has produced 132.42% cumulative profit this year. Supraobs is a decentralized cryptocurrency asset investment platform combined with online casino games for the most-efficient financial growth on the Ethereum decentralized financial DeFi ecosystem. The DeFi model helps to exclude the role of mediator. Supraorbs is an Ethereum DeFi ecosystem that helps players to own their data and investment. It Will help players deposit their cryptocurrency to gain ORBT, and with its access, players can be engaged in online gambling experiences and withdraw their winning amount anytime. Supraorbs is powered by blockchain technology, AI, and casino gamification, providing users the advantage of earning an average maximum interest rate by just investing in these decentralized platforms. For the upliftment and financial growth of the homeless, needy, and poor people, many opportunities are lingering. It is an online gambling solution for UK and US gambling users. Statistics have revealed that online gambling is a booming sector within the EU, with gross gaming revenue(GGR) expected to reach 29.3 billion euros in 2022. Still, it is centralized and is taking people to bankruptcy depths. Supraorbs will overcome all these blues by producing a transparent and independent ecosystem where users will eventually face victory. Voila! Online gambling platform awaits all its worthy users to be a part of it. About Supraorbs The fusion of blockchain and online gaming produced Supraorbs. It is a decentralized and autonomous platform. Specially designed for gamers, people who are into betting and casinos. It is a game-changer for casino industries, which will profit the players without risking their essential details. The players have control over their data and thereby maintain the privacy of the records. Cybercrimes such as frauds, data thefts, hacking, and password leaks are thus prohibited. Supraorbs uses ORBT tokens that can be exchanged with any cryptocurrency or vice versa. Besides, a gamer can earn huge profits with complete data security and control. Thus, Supraorbs is the need of the modern digitized society. About WSCF Global WSCF Global is a platform where you can find solutions to your problems technically. It is a demand-for-a-digital-world that functions as a decentralized democracy. WSCF is a community that helps businesses to upsurge at a competitive level by providing knowledge of the latest tools and technologies at the best costs. Business growth occurs through one's resources. Harmony and prosperity are the critical factors of WSCF, where authority and control are not centralized. Thus, it connects and links people to maintain transparency for public welfare. Blockchain Technology provides transparency through a hyperledger that sequentially contains records, be it transactional records, contracts, assets, or identities, and protects people from counterfeit or second-hand products. Data is within the control of the respective consumer. There is no mediator or any fear of hacking and cracking. Helps in tracking the product's shipping by monitoring its location. With digitization, the market is prone to the risk of forgery and fraud to a great extent, and to eliminate it, one must support a community like WSCF that revolutionizes the world to be a better place to live. Contact: WSCF Global Visit us at: http://wscf.io/ Email: [[email protected]](mailto:[email protected]) Phone: +911357961342
Gambling Market Size, Business Share | Growth Rate 2020 Demand Status, Revenue by Global Regions Forecast to 2025 Report by Industry Research.co
https://preview.redd.it/xjhrt7bmej261.png?width=600&format=png&auto=webp&s=ba0c5d69a3b70e0d4d94fd6a5443214a215081fe "Final Report will add the analysis of the impact of COVID-19 on this industry." Global “Gambling Market” share report highlights various trends and dynamics, new and innovative technology, and mergers & acquisitions that are expected to make a positive impact on the overall industry. Gambling market has been studied in terms of applications, specifications, and quality, which makes a positive impact on the growth of the businesses. The pandemic of Coronavirus (COVID-19) has affected every aspect of life globally and this report covers the current COVID-19 impact on the Gambling market growth. Get a Sample Copy of the Report at -https://www.industryresearch.co/enquiry/request-sample/16170892 Global Gambling Market research report growth rates and the market value based on market dynamics, growth factors. The complete knowledge is based on the latest innovations in the industry, opportunities, and trends. In addition to SWOT analysis by key suppliers, the report contains a comprehensive market analysis and major player’s landscape. The report also includes detailed information about the market players that are operating in the market. Some of the major industry players that are listed in the report include:
Betsson Group
Casino di Campione
Galaxy Entertainment Group
Camelot Group
Paddy Power Betfair
Betclic
INTRALOT
Bet-at-home.com
The Casino at the Empire
Casino Estoril
MGM Resorts
888 Holdings
Casino de Monte Carlo
Resorts World Birmingham
New York State Lottery
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Lottery
Betting
Casino
Others
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Offline
Online
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Which regional market is covered in terms of market share and size?
Who are the most-established players in the global Gambling market landscape?
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Inquire or Share Your Questions If Any Before the Purchasing This Report -https://www.industryresearch.co/enquiry/pre-order-enquiry/16170892 Geographically, the detailed analysis of consumption, revenue, market share, and growth rate, historic and forecast (2015-2025) of the following regions are covered:
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Europe
Asia-Pacific
Middle East & Africa
South America
The Gambling Market Report Provides:
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Pore Strips for Teeth Market Size Analysis by SWOT Analysis, Competitive Landscape 2020 Top Key Players, Global Share, Revenue and Growth Analysis till 2026 | Industry Research.co
"Final Report will add the analysis of the impact of COVID-19 on this industry." This comprehensive study provides a forecast and analysis of the global “Pore Strips for Teeth Market”. The report unfolds rare and distinguished intelligence regarding the market dynamics including drivers, threats, restraints, and opportunities present in the Pore Strips for Teeth industry. The report sheds light on suppliers to end-users, along with several macro-economic indicators. The research propounds crucial insights regarding the growth trajectory of the Pore Strips for Teeth market. Get a Sample Copy of the Report at -https://www.industryresearch.co/enquiry/request-sample/16070847 About Pore Strips for Teeth Market:
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This report focuses on global and Japan Pore Strips for Teeth Global and Japan market.
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Who Enjoys the Paddy Power Offers
https://preview.redd.it/sy4uqcwe1mx51.jpg?width=600&format=pjpg&auto=webp&s=49579eb87c70e333cba73cdc1b1a20849ce161bb Sport bettors and casino players can take advantage of Paddy Power sign up offer and they have many opportunities at their disposal. There is a casino bonus in fact, in case you are more likely to spend time in that section. The regular bonus is of £40 and even 20 free spins and the live casino bonus consists of 10 Golden Chips to play the Live Roulette. It is important to select a bookmaker that is licensed, reputable, has many markets to choose from and bonuses. The good news is that you can easily find out the Paddy Power sign up offer and claim it, especially if you visit a website that rates sportsbooks and points out the most trusted ones. If you like the idea of betting on sports and playing casino games, then Paddy Power is the right choice, especially since you can test out the platform with the Paddy Power sign up offer.
Confrontation: Coronavirus VS Gambling business For many years, the authorities of almost all countries of the world have been fighting a nervous battle with the gambling business. Underground casinos are opening everywhere and the authorities are again throwing all their forces into the fight against betting. https://preview.redd.it/2b4l9qv0bhr51.jpg?width=1600&format=pjpg&auto=webp&s=86b7cfdadbe8b04bd9c1de8397ef4aebc96db3c6 But then it appears: Super Coronovirus! This whole situation is like a fairy tale about a Golden egg, which everyone tried to break, but only the mouse did it. In a few months, the Coronavirus infection managed to do what the Supreme rulers of humanity took decades to do – it "killed" the gambling business! But is this really the case? Are there no more places in the world where you can drink a glass of whiskey and bet a couple of bucks on zero? https://preview.redd.it/79emqy92bhr51.jpg?width=1000&format=pjpg&auto=webp&s=7ac545a98144399601003c8f746ff04c0fcd46e0 The editorial of MetaCasino.pt has prepared an analytical material for you, about which branches of the gambling business were most affected by the Coronavirus. Land-based casinos The first and most powerful impact of the Coronavirus was on land-based stationary casinos. In the face of an epidemiological threat, people tried to leave their homes and stay in public places as little as possible. https://preview.redd.it/0h1c0f63bhr51.jpg?width=1382&format=pjpg&auto=webp&s=4140fb9b46e591860ab299c3d1a8b2c6dc88c93a ● USA The famous Las Vegas, which worked smoothly during the first and Second world war, turned into a Ghost town in a matter of months. Its casinos closed for the first time since 1963, the year President Kennedy was assassinated. According to the latest statistics, the total losses of Las Vegas casinos amounted to more than 5.5 billion dollars. ● Czech Republic Although the Czech Republic had the fewest cases of Coronavirus infection, King's Casino, which is a venue for major international poker events, had to cancel all tournaments and close for a period of quarantine. According to official data, the casino's losses amounted to about 5.5 million dollars. ● Austria The famous Concord Card Casino, which was supposed to be 25 years old this year, was closed due to the inability to pay taxes to the state. The main specialty of this casino was poker, but in early March, the institution declared bankruptcy. The main reason is the lack of clients due to the Coronavirus epidemic. https://preview.redd.it/0l9fisb4bhr51.jpg?width=2000&format=pjpg&auto=webp&s=fa81f63019dcee723f6cabdac628b7859f925187 Owners of land-based casinos are recommended to start developing the online component of their gambling houses as soon as possible so that the Coronovirus does not completely sink their business. Online casino against Coronavirus But the online casino, on the contrary, is experiencing its best times. In a situation when almost the entire world was in prison, many of the boredom began to "spend" honestly earned coins in the casino. In this regard, our editorial staff has prepared for you the TOP 3 online casinos that not only earned money during the epidemic, but also managed to bring their brand to the world level. ●Rox Casino A casino that everyone already knew about, but they learned even better during the Coronavirus period. According to unofficial data (after all, who will tell us the truth) on the excitement of their customers, Rox managed to earn about 4 million dollars. And this is almost 13% more than the casino's income before the Coronavirus epidemic. https://preview.redd.it/7fj1oyg5bhr51.jpg?width=2000&format=pjpg&auto=webp&s=9567d544c0b60efeef1d120e4bada83dee2bd507 ●All British Casino The most famous British online casino, with which, according to rumors, Prince Harry liked to spend his free time during the pandemic, managed to increase its revenue by up to 24%. And this is despite the fact that gambling is illegal and the UK government has introduced strict regulatory measures regarding online gambling and betting. The high attendance of this platform has brought All British Casino to a new level and attracted customers from all over the world. ●BoVegas And while real Las Vegas endures its worst times, virtual Vegas is on top of the glory. In the face of fierce competition and in order to attract the maximum number of new customers and keep the old ones, a welcome bonus of 5000$ was introduced. Either a gift from the company, or boredom, but the number of players for the period from January to may increased by 40%. And where new players - there is profit! Sports reference: offline or online? The sphere of sports betting has suffered the most. The fact is that the absence of Grand sporting events such as the world Cup, the UEFA Champions League, the League of Europe, the Wimbledon tennis tournament and many other competitions were either canceled or postponed indefinitely. According to the analytical company Standard & Poor's, the betting market fell by almost 37%. This has never happened before! https://preview.redd.it/pqe35ocbbhr51.jpg?width=1192&format=pjpg&auto=webp&s=3f484570f0b8f23aa7a89b693d998c5fd202a021 For example, in the UK, the demand among both beginners and professional bettors for betting shops that specialize in sports has decreased by 41%, and this is despite the fact that the demand for online casinos is growing on the contrary. In addition, during the quarantine period, offices are prohibited from using topics such as Coronavirus and self-isolation for advertising purposes. "And if there is no sport, then there is no point in betting" - you might think. But it wasn't there! Global companies such as 1xBet began offering their clients an alternative-Belarusian football. As you know, there is no Coronavirus in the Republic of Belarus – so the President of the country said. This means that there are no reasons for changes in the gambling services market. In this regard, many ratting corporations offer their clients to bet on the Top League and the football championship in Belarus. This is certainly not the European Cup, but in the context of a pandemic, you do not have to choose very much. The second birth of e-Sports E-Sport has become an excellent alternative to standard sports betting. According to the latest analytical data, e-Sports betting activity looks something like this: ● 73% - FIFA cyber football ● 21% - Counter-Strike ● 5% - Dota2; ● 1% - Other games; And as for the world e-Sports Championships, no one canceled them. This means that e-Sport is one of the few industries where avid players carry their money in the hope of getting an adrenaline rush and earning a couple of hundred dollars. For example, the FIFA cyber football world Cup and the NBA 2K20 cyberbasketball tournament are waiting for us. Thus, e-sports, whose popularity has grown rapidly in recent years, as well as betting on e-sports have received an additional impetus to even greater development. Alternative betting However, bookmakers are well aware that you can not deprive their customers of the pleasure of gambling and offer alternative ways of betting. https://preview.redd.it/huelwhicbhr51.png?width=1200&format=png&auto=webp&s=32c1f822161d24f42ea2c34ab7c4a59c2096117e So, for example, you can bet not only on local social events in your country, such as when the football season resumes, or the League of Europe. However, the most popular bet was on Coronovirus. Betters around the world are betting on when the pandemic will end, whether the borders of States will open, and whether there will be a second wave of the epidemic. Conclusion Thus, it is safe to say that no sphere of life, no economic or social sector could resist the Coronovirus. But as far as gambling business is concerned, everything is ambiguous. Actually, everything is like in betting: someone wins, such as online casinos, and someone suffers losses, such as sport ratting. But we believe that sport betting will return as the Phoenix bird as soon as all sporting events resume.
Beauty and Personal Care Products Market Size 2020 With Top Countries Data, Industry Analysis by Regions, Share, Revenue, Prominent Players, Development Strategy, Business Prospect and Forecast to 2025
📷 Global “Beauty and Personal Care Products Market” is a comprehensive research that provides information regarding Beauty and Personal Care Products market size, trends, growth, cost structure, capacity, revenue and forecast 2025. This report also includes the overall study of the Beauty and Personal Care Products Market share with all its aspects influencing the growth of the market. This report is exhaustive quantitative analyses of the Beauty and Personal Care Products industry and provides data for making strategies to increase Beauty and Personal Care Products market growth and effectiveness. Get a sample copy of the report at - https://www.industryresearch.biz/enquiry/request-sample/15711090 The Global Beauty and Personal Care Products market 2020 research provides a basic overview of the industry including definitions, classifications, applications and industry chain structure. The Global Beauty and Personal Care Products market report is provided for the international markets as well as development trends, competitive landscape analysis, and key regions development status. Development policies and plans are discussed as well as manufacturing processes and cost structures are also analysed. This report additionally states import/export consumption, supply and demand Figures, cost, price, revenue and gross margins. "Final Report will add the analysis of the impact of COVID-19 on this industry."
In COVID-19 outbreak, Chapter 2.2 of this report provides an analysis of the impact of COVID-19 on the global economy and the Beauty and Personal Care Products industry.
Chapter 3.7 covers the analysis of the impact of COVID-19 from the perspective of the industry chain.
In addition, chapters 7-11 consider the impact of COVID-19 on the regional economy.
To Understand How Covid-19 Impact Is Covered in This Report - https://www.industryresearch.biz/enquiry/request-covid19/15711090 The objective of this report: Under COVID-19 outbreak globally, this report provides 360 degrees of analysis from supply chain, import and export control to regional government policy and future influence on the industry. Detailed analysis about market status (2015-2020), enterprise competition pattern, advantages and disadvantages of enterprise products, industry development trends (2020-2025), regional industrial layout characteristics and macroeconomic policies, industrial policy has also been included. From raw materials to end users of this industry are analyzed scientifically, the trends of product circulation and sales channel will be presented as well. Considering COVID-19, this report provides comprehensive and in-depth analysis on how the epidemic push this industry transformation and reform. Global Beauty and Personal Care Products market competition by TOP MANUFACTURERS, with production, price, revenue (value) and each manufacturer including:
Unilever
Procter & Gamble Co
Beiersdorf AG
Avon Products, Inc.
Avon Products Inc.
Revlon, Inc.
L'Oreal S.A.
Estee Lauder Companies Inc.
Global Beauty and Personal Care Products Market providing information such as company profiles, product picture and specification, capacity, production, price, cost, revenue and contact information. Upstream raw materials and instrumentation and downstream demand analysis is additionally dispensed. The Global Beauty and Personal Care Products market development trends and marketing channels are analyzed. Finally, the feasibility of latest investment projects is assessed and overall analysis conclusions offered. Enquire before purchasing this report - https://www.industryresearch.biz/enquiry/pre-order-enquiry/15711090 On the basis of product, this report displays the production, revenue, price, market share and growth rate of each type, primarily split into:
Hair Care Products
Facial Care Products
Shower Gels
Oral Care
Men's Grooming Products
Deodrants and Antiperspirants
Cosmetics/Make-up Products
On the basis of the end users/applications, this report focuses on the status and outlook for major applications/end users, consumption (sales), market share and growth rate for each application, including:
Specialist Retail Stores
Supermarkets/Hypermarkets
Convenience Stores
Pharmacies/Drug Stores
Online Retail Channels
Others
Geographically, the detailed analysis of consumption, revenue, market share and growth rate, historic and forecast (2015-2025) of the following regions are covered in Chapter 6, 7, 8, 9, 10, 11, 14:
North America (Covered in Chapter 7 and 14)
Europe (Covered in Chapter 8 and 14)
Asia-Pacific (Covered in Chapter 9 and 14)
Middle East and Africa (Covered in Chapter 10 and 14)
South America (Covered in Chapter 11 and 14)
Some of the key questions answered in this report:
What will the market growth rate, growth momentum or acceleration market carries during the forecast period?
Which are the key factors driving the Beauty and Personal Care Products market?
What was the size of the emerging Beauty and Personal Care Products market by value in 2019?
What will be the size of the emerging Beauty and Personal Care Products market in 2025?
Which region is expected to hold the highest market share in the Beauty and Personal Care Products market?
What trends, challenges and barriers will impact the development and sizing of the Global Beauty and Personal Care Products market?
What are sales volume, revenue, and price analysis of top manufacturers of Beauty and Personal Care Products market?
What are the Beauty and Personal Care Products market opportunities and threats faced by the vendors in the global Beauty and Personal Care Products Industry?
Years considered for this report:
Historical Years: 2015-2019
Base Year: 2019
Estimated Year: 2020
Beauty and Personal Care Products Market Forecast Period: 2020-2025
Revolut no longer accepted for UK licensed gambling operators
The UKGC has put a ban on payments to online gambling operators using credit cards, and also any money service business which allows funding through credit cards. This also specifically includes Revolut. So anyone using their Revolut card to play online casinos, this will no longer work if the casino is operating within the law. Source.
For clarity, and further to specific queries raised by operators, this includes electronic money institutions such as Revolut which has confirmed that its customers can add money using credit cards. Operators must therefore put systems in place to prevent gambling payments from these products.
New Dawn Aurora: What are the top 10 Toxic Masculinity behaviors?
This list is a bit shocking (IMHO)...
Being stoic
Men are constantly given the message that they must be self-reliant, independent, physically tough etc. Men are told that to be this way will make them successful in terms of business, society, and finding a partner. Being vulnerable will cause men to be ridiculed.[1] [2] [3]
Being promiscuous
Typically, men will be praised by other men for sexual conquests. There is a well-known double standard regarding perceptions of male versus female promiscuity with men being praised by their peers and called ‘studs’ while rejecting women who have multiple partners and branding them ‘sluts’.[4]
Being heterosexual
Many men are programmed to react negatively to the concept of homosexuality as it is a sign of deviating from the traditional male stereotype. Through popular rhetoric and from an early age when boys are learning about gender roles, men are taught that to be homosexual is to be less masculine.[5]
Being violent
Statistically, men commit significantly more violent crime than women. There are numerous reasons for this, but there are clear links between male instigated violence and the need men have to use aggression and violence to prove their masculinity and bolster confidence in their masculine identity.[6] [7]
Being dominant
To be preoccupied with power and dominance to a point that it causes harm to others, such as verbal, physical and online bullying. One study found that over a quarter of men thought they should have the final word in relationships, over a third of men believed that they had the right to know where their female partner was at all times.[8]
Sexual aggression towards women
Men who conform to toxic masculinity standards are more likely to make sexual comments or sexist jokes to women, commit sexual harassment, accept rape myths and behave as if they are entitled to women’s bodies.[8][9]
Not displaying emotion
Emotion is treated as being a feminine characteristic. Stifling emotion is seen as true manliness. From childhood, males are shamed to conform with the standard that to show emotion is weak and feminine.[10] [11] [12]
Not being a feminist ally
It is unsurprising that the overly masculine would reject men who identify as the allies of feminists. Research shows that men engaging in feminist activism are the targets of harassment by men who prescribe to toxic masculinity as it is perceived as feminine and non-conformist to toxic masculinity.[13]
Risk-taking
Connected to male dominance, toxic masculinity encourages taking risks to demonstrate dominance, men who buy into this are more likely to take extreme measures such as perpetrate violence, drive dangerously, gamble, abuse drugs.[14]
Not engaging in household chores and caregiving
Again, housework and childrearing are seen as feminine qualities. Being asked to do a feminine deemed task such as housework, or worse, a man being criticised by a woman for not cleaning appropriately is often interpreted as an emasculating assault and provokes a masculine overcompensation response.[15]
I guess men have to walk a pretty narrow (and largely contradictory) path. But apparently that's not enough...
Violence and recognising it is a male problem
It is absolutely necessary to address the elephant in the room and acknowledge that there is a connection between issues such as violence and sex based oppression. Few will be surprised to hear that males commit nearly 90% of violent crimes in the USA.
* “Physical aggression is a socially constructed gendered behaviour embedded in the social meanings of masculinities across many cultures. The general unwillingness of people to recognize that violence is a men’s issue is also reflected in the broader scientific literature.” Kilmartin & McDermott.[20]
And where is this stuff from?
Aurora New Dawn
is a registered charity giving safety, support, advocacy, and empowerment to survivors of domestic abuse, sexual violence and stalking.
I made a comprehensive guide for those of you lurkers who suffer from extreme constipation
I now maintain an updated and more user-friendly version of this guide at /ConstipationAdvice. I've seen that many of you have chronic constipation but you do not understand why you have it, and your general practitioner doctors either don't think you have an issue or don't know what to do. I know how you feel. I know what it's like to not even feel like a human being because you can't go to the bathroom like everyone else. It is frustrating and depressing, and not something you can just go around telling people. I hope this guide helps you a ton. BECOME A DETECTIVE Keep this in mind as you proceed: your disorder is a puzzle. All you have to do is solve it. You can do it, if you have a great deal of patience, persistence, and commitment. Become your own investigator. Figure out your digestive cycle and your body's language. Listen to your body. Keep notes - I'm talking handwritten or typed notes, anything that will help you make a paper trail. Women: I have left a special note for you at the bottom regarding the additional problems you face when dealing with doctors. Please read it. WHY I MADE THIS GUIDE I'm a (mostly) healthy, physically active 31-year-old male. I have spent years seeing doctors, reading studies, accosting and interrogating medical professionals and pharmacists, calling pharmaceutical companies, and generally being an interrogator to anyone who has information that could help improve my life. This post is the aggregation of my conclusions and recommendations. In 2012 I got constipated. I grabbed an OTC laxative and was fine after that. But then the constipation happened again a few months later. It became more frequent, going from once a month to once a week, to every day. As of 2016, I was completely unable to eliminate without the use of pharmaceutical drugs. It took seven years for doctors to figure out what was wrong with me. I made this post because I want to help some of you turn my 7-year journey into a 7-month journey. Print this guide out and keep it with you. I've done all the heavy lifting for you. I did all of these myself, and now I want to help you. You will spend money on all of this, but it will change your life. You will be glad you did it. QUESTIONS FOR YOU If you suffer from severe chronic constipation, you need to answer the following questions, write them down, and bring them to your doctor:
Do you have the urge to go, but you cannot? Or do you have zero urge to go? (this is the most important question)
Do you have alternating diarrhea and constipation, or just constipation?
Do you have nausea, vomiting, acid reflux, difficulty swallowing, or early satiety (getting full really early into a meal)?
Have you had this issue since childhood, or did it begin in teen years/adulthood/after a major life event (surgery? divorce? car accident? mauled by bears?)
Did you in the past or do you currently take any medications that could damage your intestines? The acne drug Accutane/Sotret/Claravis/many other names (isotretinoin) has been linked to serious conditions of the digestive tract. I am absolutely convinced that my large intestine was destroyed by this drug. Antibiotics are also a major culprit in ruining the small intestine microbiome and causing diarrhea/constipation disorders. Antidepressants can ruin the serotonin balance in the gut as well.
Did you suffer sexual abuse as a child? There is a high degree of correlation between childhood sexual abuse and adult constipation disorders. Meaning, a lot of people with chronic constipation disorders in adulthood experienced trauma when they were young. This sort of thing must be investigated by both your doctor and a therapist in coordination. Do some Googling on this topic if you believe this might be your issue.
If you have the urge but cannot go, you very likely have Pelvic Floor Dysfunction, especially if you are a woman who has had children. Other indicators of PDF are pain during sex and incontinence. Sorry, but your test is the anorectal manometry - have fun! It can sometimes be treated. Alternatively, you might have a bowel obstruction or a tumor. Your doctor must test for these. If you have zero urge to go to the bathroom, you very likely have a nerve or muscle disorder of the large intestine. These are called motility disorders. This is what I have. The most common are Slow-Transit Constipation, Chronic Idiopathic Constipation, and the dreaded Colonic Inertia. Both are extremely frustrating and difficult to treat. It is especially likely that you've got one of these conditions if you have no associated pain or any other symptoms. Your current gastroenterologist likely specializes in IBS; tell him you want a motility specialist or a neurogastroenterologist. If you have constipation sometimes and diarrhea sometimes, you very likely have IBS-C or a rare form of colitis, or a combination of issues. You may have a nervous condition. Outside chance you have Crohn's Disease. You must be checked for intestinal ulcers/irritation/inflammation, and also for food intolerances and allergies. A buddy of mine had "IBS" for many years, but then later discovered he was allergic to tuna, shellfish, pistachios, and fructose. If you have nausea, vomiting, acid reflux, difficulty swallowing, or early satiety, you very likely have general gastroparesis, where your entire GI tract is sluggish. I'm sorry to say that this is very difficult to treat and a horrible disease. You must see a neurogastroenterologist, AKA a gastroenterologist who specializes in motility disorders, and you must also see a neurologist to test for autonomic neuropathy. You need a prokinetic motility drug like cisapride, domperidone, prucalopride, etc. Don't go on cisapride unless you have excellent heart health and make sure the doctor keeps an eye on your heart at all times. If you have experienced constipation since childhood, you might have Hirschsprung's disease and you need a neurogastroenterologist (a special type of gastroenterologist who studies nerves and motility) to diagnose it by taking a Full-Thickness Biopsy. This is a major surgery and you should try to exhaust all other options first. The Full-Thickness Biopsy comes with its own potentially serious side effects. If you took heavy medications that could possibly have caused your issue, first write out a timeline of events and try to remember exactly when you took the medication and when your issues started. Write down the progression of symptoms and severity. Bring it with you to your doctor appointments. Correlation does not imply causation, but you are a detective now and you need to follow every lead. You need to insist to your GP that you want to see a gastroenterologist (a specialist of your digestive tract, from your mouth to your anus). You need to advocate strongly for yourself because nobody else is going to do it for you. You have to be aggressive in your appointment-making, follow-ups, call-backs, consultations, and arguing with your insurance company about getting your specialty medications covered. You have to do it yourself. You have to fight. If you don't, you will suffer alone. Nobody is going to save you but you. It's time to get smart and tough about your condition. THE FIVE FUNDAMENTAL TRUTHS You are embarking on a journey to improve your health and to discover the cause of your digestive issues. Rather than force you to stumble upon these facts yourself, I'm just going to lay them out for you:
Your general practitioner (AKA "family doctor") does not know anything about your condition. He is not an expert in diseases of the large intestine. With a few exceptions, he is a gatekeeper for the experts that actually can help you. He will only refer you to these experts after you complete a few basic tests. Do them quickly.
The specialist your GP refers you to is also probably not an expert in your condition. Once you arrive at the specialist's office, ask him what his specific expertise is. It took me a year to realize that my specialist was an expert in liver cancer. Womp womp. Your disorder is likely in your large intestine, and your specialist may have spent the years of his fellowship removing nodules from the esophagus. Ask him who he knows that is an expert in motility disorders, and if he doesn't know anyone, tell him to find one and send you there.
You have to elbow your way through the medical system like a Muay Thai fighter if you want to get anywhere. Make your GP give you a referral to a specialist. Make that specialist refer you to the right specialist. Make that specialist order a bunch of tests. Then make him lay out a treatment plan for you.
Your insurance is going to act like all of your tests and prescriptions are "experimental." Experimental is insurance-code for "F*ck you, we aren't paying for this." The magic spell to banish this bullshit is the phrase "medically necessary," and only your specialist has the power to utter it. Make sure he does, on all of your prescriptions and test orders.
Your digestion operates in a cycle - just like your sleep cycle. Pay attention to it, listen to it, memorize it. Know the foods your body hates, know what throws your cycle off, know what improves it. Most importantly, once you have the cycle memorized, track its rhythm over a long period of time. After a year or two, you may notice some changes to the cycle. This information is key.
TESTS YOU PROBABLY NEED First, work your way through the following tests with your general practitioner:
Standard blood panel to check for any really wacky levels/deficiencies
Celiac blood panel to eliminate the small possibility that you have Celiac
Fecal blood test. Blood = tumors, ulcers, or perforations
Then, once you have a referral to a gastroenterologist, have him perform the following tests:
Extensive stool cultures: look for rare parasites. Small chance you have SIBO, very small chance you have SIFO, very very small chance you have a Clostridium infection that paralyzes the bowels. Ask the doctor to ensure Clostridia are tested for.
Extensive thyroid panel (sometimes hypothyroidism causes gastroparesis / slow gut transit. This one's an EASY FIX; pray you have this one). You want a full workup, not the standard one.
SITZ Marker Study: The lab will not know what this is or why you're doing it. Follow the doctor's instructions carefully. Do not take laxatives during this study (it lasts a week) because the point is to identify which specific part of your large intestine is broken (ascending, transverse, descending, rectum). If you accelerate transit by taking laxatives, you will give the lab a false result and it will screw up your treatment.
Endoscopy with small bowel aspirate and biopsy; and colonoscopy with biopsy: If you're under 30 your doctor will fight you on this. He is an obstacle. Defeat him. Also, specify that you want two types of biopsies performed: a normal biopsy of the small intestine to check for Celiac and Crohn's, and an eosinophilia biopsy to check for allergies. They won't do this unless you specifically request it. Don't screw up the pre-op prep, no matter how hungry you get. If your condition is severe enough, ask about the Full-Thickness Biopsy which tests for ganglionic nerve density / Hirschsprung's disease. This is a very serious surgery and I urge you to get a second opinion before having it done.
Anorectal manometry and MR Defacography: The anorectal manometry is critically important for people with severe constipation disorders. It really sucks to get it done, but do it.
The AM / MRD test suite is sometimes described as a "motility workup" and it can only be performed at highly specialized GI clinics. You will need to pressure your doctor to help you find one, tell him to contact your insurance company and declare these tests medically necessary. This is a battery of humiliating tests to determine if you have PFD or another nerve-related motility disorder. If you have a good sense of humor and are capable of relaxing in embarrassing situations, it'll be easy.
CT Scan with contrast: This is the one where you drink the radioactive dye and lay down inside a space ship. The point is to find tumors, divurticula, obstructions, etc. Ask the radiologist what s/he sees. Sometimes they'll slip up and tell you. They can't say "You don't have cancer" (that's for your doctor to determine) but they can say "I don't see any tumors."
Risks: Some redditors have expressed disagreement with the CT scan's former position on this list (it was higher up), citing the patient's exposure to radiation as dangerous. They argue a CT scan should only be performed after a colonoscopy. To be clear, a CT scan exposes you to much more radiation than a regular X-ray, but only about 1 in 2000 people develop cancer as a result of a CT scan, and that cancer generally occurs late in life. The reality is, the purpose of the scan is to help diagnose and treat a condition that is debilitating and potentially dangerous to you right now, and you are weighing that benefit against the potential prospect of cancer later in life. Talk with your doctor about the risks vs benefits. Ask him/her if you should do it before or after a colonoscopy. You will have a diagnosis after these tests. If none of these tests result in a clear diagnosis: see my comment here for next steps. TREATMENTS AND MEDICATIONS Disclaimer: I am not a doctor. Make sure to clear each of these with your doctor before proceeding. Do not gamble with your own health. Cycle through these home remedies and request these medications from your doctor, in roughly the following order:
Do all the stupid fiber crap just so you can tell your doctor to shut up about it. Fiber does not help people with motility disorders (people like you, probably). It will not help you - unless you have a lack of the Prevotella bacterium in your gut microbiome. Increasing your roughage intake and eating a plant-based diet will increase your Prevotella count, and might alleviate your condition. If the extra fiber constipates you more, move on.
Cut out all dairy immediately for a month. Dairy is delicious and makes live worth living, but it is disgusting and terrible for you. Almond milk, almond milk ice cream, rice milk, dark chocolate...get used to it.
Cut out all gluten for a month and stick to it. Wheat is insanely hard to digest for almost all people and it causes nothing but problems for people with bowel disorders. Even if your Celiac panel comes back negative, you still might have Non-Celiac Gluten Sensitivity, which is still being researched but quite prominent. Many people immediately see results after cutting gluten. But look out - the shit's in BBQ sauce, soy sauce, it's in the air, it's in the water, it's in your pillow, it's everywhere. It's as if the USDA has an agreement with US farmers to sprinkle wheat in literally every f*cking food product.
Try the FODMAP diet and stick to it. Eliminate all potential dietary causes of your constipation, then reintroduce them one at a time to identify the culprit. For 90% of you, diet has nothing to do with your constipation. You have a nerve disorder. As a rule of thumb, grains are all difficult to digest and should be avoided, but I've found that potato and corn are easiest, rice is a bit harder, and wheat and oat are the worst. No idea about quinoa. I strongly recommend sweet potato as a healthy filler replacement for breads. It doesn't even need butter!
Try a few high-quality probiotics. People with intestinal motility disorders have different gut microbiota than normal people, but scientists aren't sure which is the cause and which is the result. A 2015 study showed that Bifidobacterium, Lactobacillus, and Prevotella are significantly reduced in people with functional constipation disorders, and their clostridia counts were higher. (Clostridia is bad and requires antibiotics. You can determine if you have this by asking your doctor for a Clostridia-specific stool culture test.) Try Visbiome, VSL#3 if you can find/afford it. Also, try one of these. You want enteric-coated capsules that are not broken down by your stomach acid so they make it to your intestines.
Miralax (polyethylene glycol) is your first line of defense. It's a chemically inert (non-reactive) substance that you mix in water and chug. It's an osmotic laxative, meaning it does not stimulate the nerves/muscles in the intestines. It draws water into the bowel and flushes you out. It works slowly; it might take several days to work. The mainstream medical consensus is that polyethylene glycol is extraordinarily safe and can be used in babies, the elderly, etc. It can be used for years and years. However, there is some evidence now that it's bad for the environment and probably not as good for people as we thought. I'm ignorant of chemistry, but polyethylene sure sounds like plastic to me.
If you need fast relief, go to a health food store with a supplement section and buy a bottle of Magnesium Citrate powder. It must be citrate, and it must be powder. Mix 450mg (usually a heaping teaspoon) into a tall glass of water and chug it as fast as you can. Do this on an empty stomach in the morning before breakfast. If your disorder is mild, you will have to take a dump immediately. Don't get in the car to go to work for a little bit. MagCit is extremely safe and effective. Doctors prescribe it to old people for years and years with no side effects. But if you have renal disorders (kidney problems) talk to your doctor before trying this.
I find that MagCit works best for me right before bed. I have to wake up in the middle of the night to pee out all the water I chugged, but in the morning, I generally am able to empty. By the way, MagCit is also an osmotic laxative.
Cayenne pepper capsules have been used in combination with magnesium citrate with great success in some people. The pepper stimulates peristalsis in the large intestine, and the magnesium draws water to the large intestine. Combined, they propel your gut's contents along. These capsules can be obtained at any health food store with a supplement section; you can get them and magnesium citrate in the same store usually. Be warned, some people report a mild burning sensation both in their esophagus and their rectum (basically like when you eat some really spicy food and it gives you the runs). The regimen I've read that works best is a heaping teaspoon of magnesium citrate in a large glass of water, chased with 1 or 2 Cayenne capsules before bed produces a BM the next morning. Start with a low dose. When you buy the capsules, they'll have a heat rating, usually between 40,000 - 90,000 HU.
Request Lactulose from your pharmacy. It's basically a sugar that helps with bowel transit. Didn't work for me, but it works for some.
Docusate is an OTC stool softener that makes me nauseous and does nothing else, but maybe it'll work for you. MagCit beats its brains out.
Bisacodyl is your go-to OTC stimulant laxative. In the US it's known as Dulcolax, but there are off-brand boxes that are cheaper and similarly effective. Use this carefully. It can exhaust the muscles in your intestines, so while you get relief one day, the next two days you're in a refractory period where constipation starts up again. Use 10mg 2x per week if you have insanely bad constipation like me. Don't exceed twice per week. Use 5mg if you're underweight. Safe to use with MagCit. I like using it in the morning on an empty stomach and I'll skip breakfast that day. The more food you have in your digestive tract, the longer it takes. Empty stomach = 2-4 hours, full = 8-12. Long-term use is frowned upon but there's no actual evidence whatsoever that it causes a problem. Read the case studies if you don't believe me.
L-Arginine is an over-the-counter supplement available at health food stores. It is used by athletes to increase cardiovascular health, but it has a magic side effect: diarrhea! Why? Because it breaks down into nitric oxide synthase, which regulates bowel transit time, and researchers recently discovered is deficient in people with motility disorders. See this conversation for more details. Also, taking this supplement with a small amount of baking soda might increase its effect, according to some athletes who experienced intense diarrhea after doing so (they like baking soda because it reduces acid production / muscle soreness). Oral dosages vary from 2-6 grams but some people go higher. Be careful and talk to your doctor first. L-arginine is also available in suppository form and there is good evidence to believe these are safer and much more effective.
Amitiza (lubiprostone, prescription): Your doctor might prescribe this first. It's an expensive prescription osmotic laxative. It causes nausea in a lot of people and it didn't work for me, but it's a godsend for some. Try it. Take with a great deal of water. DO NOT TAKE AMITIZA WITH LINZESS, MIRALAX, OR MAGCIT BECAUSE THEY'RE ALL OSMOTICS (or behave like osmotics).
Linzess / (linaclotide, prescription, "Constella" in Canada): This is the most powerful prescription "osmotic" (it's actually a Guanylate cyclase-C agonist) in the world, and it will make your ass explode the first time you take it. It comes in strengths of 72mcg (that's micrograms), 145, and 290. I have a lot to say about this medication so read carefully. Also, if you've tried Linzess and it didn't work, please read my how to make Linzess work guide.
First of all, it has a mild prokinetic effect (meaning it stimulates your nerves) in addition to its osmotic effect. This is a good thing. Amitiza does not have this. Your digestion is on a schedule. Some of you go every day. Some every other day. Some once a week. Whatever your normal clockwork is, this medication will sometimes work and sometimes not, depending on how much fecal obstruction there is in your intestine on the day. There were times when 290mcg did absolutely nothing for me, and other times 145 made me run wide-eyed to the bathroom fifteen times in thirty minutes. You will figure out how to make this medication work after a lot of trial and error. Don't just dismiss it the moment it doesn't work. I'm of the mind that no human being should ever take 290mcg and it has got to cause long-term damage to the intestines, but all my specialists disagree. They prescribe this dose to women quite frequently for some reason. Linzess has a penchant for working very well for a few weeks, and then ceasing to work at all. Keep it refrigerated (there's a rumor that it goes bad if it gets warm, but pharmacists will not confirm this). Take it with a large glass of water and stay super hydrated all day. Water is key; it cannot work if you don't drink a ton of water with it. If this medication dehydrates you (it will), grab a bunch of those vitamin/mineral powder packets from the health food store and chug one or two a day. If you get bad headaches/migraines/weak pulse/sweats/nausea, you need to just quit the medication and talk to your doctor. Ask him to reduce the dosage. Although the prescription for Linzess is once daily, I find it works best for me taken twice per week with another medicine like Motegrity (Prucalopride) or Bisacodyl. I take it on an empty stomach in the morning and don't eat anything until it starts kicking in (which is quite fast...usually under two hours). LINZESS HAS A BLACK BOX WARNING against its usage in persons under 18. It is extremely dangerous to children. If you don't hydrate enough on a regular basis, it is also dangerous to you. It is illegal to give it to your kids. If you don't have a gallbladder, mention this to your doctor before taking Linzess. I once heard that's an issue, but I can't find a source online. DO NOT TAKE LINZESS WITH AMITIZA, MIRALAX, OR MAGCIT BECAUSE THEY'RE ALL OSMOTICS (or behave like them).
Motegrity (prucalopride, prescription): This is a brand new drug, the first in its class, and it's a 5-HT4 agonist. It works similar to some antidepressants, by targeting specific serotonin receptors in your intestines. Except Motegrity is a highly specific agonist, meaning it has a narrower range of side effects and typically won't affect your mood. This drug actually works for me, it worked immediately, it still works. Zero side effects. I take it in the morning on an empty stomach, although it can be taken without regard to food.
Most doctors in the US don't even know about Motegrity so ask them to look it up. It's brand new, meaning it's expensive. But don't worry. All of these drugs are insanely expensive. As far as I can tell it is safe to take with osmotics like Linzess but I have not confirmed this with a doctor. In my reading, I see no relevant contraindications between the two. There is a warning in the box that some people committed suicide or experienced suicidal ideation while participating in clinical studies for Motegrity. There is no statistically significant relationship established here, but the company is by law required to make this information public. Frankly, Motegrity has zero side effects on me, and I expect these people killed themselves or thought about it simply because constipation disorders are f*cking horrible and make you depressed. If you live in the UK, Europe, or Canada, your doctor will know this medication as Resolor or Resotran.
Zelnorm/Zelmac (tegaserod, prescription): This drug is similar to Motegrity (insofar that it is also a 5-HT4 agonist). It is older than Motegrity, and considered less safe because it interacts with receptors in a less specified way; there is some evidence that it interacts with cardiac receptors. In plain English this means it might be responsible for causing strokes and heart attacks in some patients. The evidence is debatable. 0.11% of people who used Zelnorm in a study experienced cardiac events, compared to 0.01% who took the placebo. That's 13 out of 11,500 people. The drug is available in the US only to women, although your doctor can order it "off-prescription" if he deems you low risk. Basically don't try this drug if you are overweight or have any notable cardiac family history.
Trulance (plecanatide, prescription): This is the main competitor of Linzess (linaclotide) and has a smaller side effect profile. It appears to work pretty well if osmotics work for you, but I haven't tried it. It also has a mild prokinetic effect (meaning it stimulates the nerves in your intestines). I assume, like Linzess, it is also dangerous to children. Give it a try.
Mestinon (pyridostigmine, prescription): This is where it gets weird. Mestinon is a drug that treats myasthenia gravis, which is a nerve disorder similar to MS. But, it can be used to treat constipation in some cases. It's an acetylcholinesterase inhibitor, meaning it increases your body's levels of acetylcholine. This is a neurotransmitter that is partly responsible for telling your intestines to squeeze. Most doctors will be hesitant to put you on it, but you can give it a try if all else fails. It has a strange side effect profile and causes fainting/blood pressure drops in some people. I never tried it.
An interesting story...there is a woman who did a bit of basement chemistry and figured out that she could spike her acetylcholine levels by literally sticking a nicotine patch on her stomach below the belly button. It caused her bowels to empty after a week of constipation. She then invented Parasym Plus, a supplement that allegedly does the same thing. I bought this and I cannot figure out if it actually worked. Maybe it did a little. There are many acetylcholinesterase-inhibiting drugs on the market. Prostigmin (neostigmine) is one of them. Ask your doctor if he thinks it's a good idea. He'll say it isn't. But if all else fails...
Lexapro (escitalopram oxalate, prescription), or any related SSRI antidepressant: Antidepressants are now being used to treat constipation. Some clever fellow figured out that the majority of serotonin (the mood-regulating neurotransmitter) is manufactured in your intestine, not your brain, and that antidepressants were giving people diarrhea for some reason. I haven't tried Lexapro but it's next on my list and my doctor likes it because of its small side effect profile relative to other antidepressants. This drug has a wider side effect profile than related constipation meds like Motegrity/Tegaserod, meaning you could have mood swings or drops/spikes in energy, etc.
Despite our overwhelmingly negative public opinion about antidepressants, they are rather safe* and effective for many people. It's just that they're over-prescribed. A low dose does help some people normalize bowel function without causing mood/personality changes. *edit: A redditor linked me to this article explaining that some SSRIs can cause long-term GI problems. The comments are worth reading. As with all pharmaceutical drugs, you are weighing your current problem versus the potential side effects of its treatment. Talk to your doctor about the risks and do your own research. Talk to friends and family members who have taken SSRIs.
Erythromycin: This is an OTC (I believe) antibiotic with a very odd side effect: it speeds up gastric emptying and gut motility. Hooray! The case studies are kind of back and forth on its efficacy for constipation, but some doctors swear by it. The problem is that it's an antibiotic.
Here's the thing about antibiotics. They should not be overused or used unnecessarily. They can seriously devastate your gut flora and cause SIBO and worsen your condition. On the other hand, your condition could have already been caused by antibiotics, or by a pathogen that will killed with antibiotics. Proceed with extreme caution.
Colchicine: This is an anti-inflammatory derivative of the autumn crocus plant. In large doses it's highly toxic, but in small doses it's used to treat Gout. However, a recent study determined that it's an effective treatment for Slow Transit Constipation / Colonic Inertia (basically any constipation disorder that does not involve physical blockage like tumors, obstructions, etc). I haven't tried this but my specialist claims it is quite safe in low doses and he would be happy for me to try it out.
For those of you who are diagnosed with slow-transit constipation / colonic inertia:Here is a master list of treatments.
MY PERSONAL REGIMEN: Some of you have asked about my specific medication regimen. After several years of trial and error, I have found regimens that basically make my life normal again. Please note how the regimen evolves over time! Intestinal diseases typically are very transient and change over the years. What works for you now might not work in a while: 2012 - 2014: Senna laxative once per week 2016: Bisacodyl and Miralax twice per week 2017: Magnesium citrate 450mg each morning before breakfast 2019:
2mg Motegrity (prucalopride) daily in morning
145mcg Linzess (linaclotide) every other day in morning
450mg Magnesium citrate before bed
EXERCISE Of all the treatments I've tried, exercise is near the top on the list of effectiveness. Exercise is a conduit for getting all of that stress and potential energy out of your body and away from your guts. Get a standing desk at work (a good company will accept a doctor's note and buy one for you). Stand for half the day, intermittently. Go on jogs in the morning and walks in the evening. Get to the gym and get your knees above your waist - stairmaster, yoga, squats, etc. Just MOVE MOVE MOVE. By doing so you are stimulating the vagus nerve and increasing motility. You will literally shake the poop out. If you live an incredibly sedentary life, you will suffer much more. SURGERY FOR EXTREME CASES Please visit my updated guide at /ConstipationAdvice for new guidance on these surgeries.
For those of you diagnosed with CI, you might be considered for the TAR IA surgery, (total abdominal colectomy with ileorectal anastomosis). This is the laproscopic removal of your entire large intestine and the attachment of your small intestine to your rectum. The nice thing about this surgery is that you still get to go to the bathroom normally, except you have mostly diarrhea for the rest of your life (because your large intestine is the thing that turns diarrhea into solid stool by absorbing water).
The other option is one of many variants of the colectomy (resection or removal of the large intestine) with colostomy or ileostomy. These are both ostomies, which is the surgical creation of a hole in your lower abdomen. A medical bag is affixed to that hole, and your small intestine drains into it instead of down into your rectum. This is a much bigger life change, but from the people I've talked to, it's surprisingly not that big a deal.
If you are interested in these surgeries you will have to have a great number of conversations with many doctors and jump through a lot of hoops. A NOTE FOR WOMEN AND TEENAGERS The feedback I get from most women is that their (male) doctors are extremely dismissive and incredulous about the woman's constipation issues. Doctors are going to act like you are crazy and hormonal. They're going to tell you to just eat some fiber and take some miralax and bugger off. You have to be strong, confident, and knowledgeable of your situation. Do not take no for an answer. Inform your doctor that you are past the standard constipation treatments and this is an ongoing problem that reduces your quality of life and warrants the attention of a specialist. It helps if you appear to know what you are talking about. Learn about your digestive anatomy and understand the difference between your small and large intestine. Understand the constituent parts of the large intestine (ascending, descending, sigmoid, transverse, rectum, etc). This will help you communicate to your doctor more efficiently and it will help you better understand his/her findings. If you show your doctor you've done your homework, it is very likely he/she will take you more seriously. Everything I just said applies to teenagers. The additional problem facing you is that you have an extra gatekeeper: your parents, and the fact that you rely on their insurance. You need to have a level-headed conversation with them about your situation, however embarrassing that may be, and convince them that they need to be advocates for you, not obstacles to you. Getting them on your side now will benefit you greatly when the doctor questions the seriousness of your complaint. A FEW FINAL NOTES
Read. You aren't going to effectively communicate or convince your doctor of anything unless you have some introductory knowledge of your body. Learn about your digestive anatomy and understand the difference between your small and large intestine. Simply knowing this information will help you come up with questions about what could be causing your issue.
Save yourself the remarkable headache and get physical and digital copies of the results of every single test you have performed, even simple blood tests. When you inevitably get transferred to a different specialist, having this stack of files will make your life so much easier.
Your insurance company is going to fight you on some of these medications. Tell your doctor to tell your insurance it is an urgent medical necessity that they cover this medication. They will fold.
DO NOT GIVE UP. Write down your next steps. Follow up on calls, appointments, etc. I keep lists of all my medical to-do's and I cross them off line-by-line. It gives me a great sense of accomplishment and control over this whole situation.
Relax and get your mind off your condition. This is hard. But there is absolutely a psychological component to your condition. For some people, it's entirely psychological (this is called Chronic Idiopathic Constipation or Functional Constipation). People who suffered sexual abuse in childhood often develop constipation disorders in adulthood. Google this and investigate it with your doctor!
I go on long nature walks with my headphones. This is how I unwind. Some people do Ju Jitsu. Some people do music. Spend time with family and engage in your hobbies. This will absolutely help, especially if your condition is idiopathic in nature.
Intractable constipation is often the result of extreme stress. Have a serious brainstorm about whether you need to quit your high-stress job. Are you in an abusive relationship? GET THE FUCK OUT OF IT. Can you afford a week-long spiritual retreat where you take a vow of silence and eat a vegetarian diet and sit in a garden with a pen and paper? DO IT. Now is the time to try all the weird stuff.
Cry whenever you have to; don't bottle anything up.
Talk to other sufferers about it. Reach out and get involved in a community. Support is everything.
Your enemy has a name. You very likely have a motility disorder. It can be caused by an underlying nerve disorder, blood vessel disorder, mechanical muscle failure, neurotransmitter imbalance, hormone imbalance, or bacterial imbalance. Once you get your diagnosis, you will not feel so confused and lost about how to treat it.
The online gambling statistics in the UK gives a clear cut idea about the business of gambling in the United Kingdom. This country has flourished the business of gamble in a quite strict, regulated and limited way, turning it into one of the economy boosters for the country. Gambling industry statistics are published twice a year (in May and November) and provide the latest information on each industry sector we regulate, which includes online gambling services offered to customers in Great Britain. The statistics come from the data provided by licence holders through their regulatory returns. Gambling is a favourite pastime among many people in the UK, and the market is increasing every year. In this article, we will highlight some of the key statistics on gambling in the UK. Gambling in the UK: the numbers It is no doubt that online gambling is a growing industry in the United Kingdom. […] The ‘UK Betting and Gaming Statistics’ release presents statistics from the 7 different gambling regimes administered by HM Revenue and Customs (HMRC):Bingo Duty The UK Gambling Commission (GC) published its bi-annual gambling industry statistics report showing growth in online gambling.The remote sector with its £5.7 billion in gross gaming yield (GGY) represented 39.9% of the total £14.2 billion generated by the industry during the reported period of April 2019 to March 2020.. The overview report in terms of GGY by sector is based on data reported 2019-statistics from Statista show the share of online gambling participants in the UK by type of gambling activity. Sports betting dominated the market, with 81.3%, and casino games were not close behind with 73.6%, while virtual dog or horse races made up 65.1%. A Look at Other Numbers. Further insights into the UK online gambling industry can be gleaned by looking at an article published in the Jerusalem Post in 2019. The truth is that there has been only a less than 10 percent increase, year-on-year, in the amount of money being spent in the UK online casinos over the past decade, as these UK gambling statistics show. Online Gambling Gross Yield – up £4,688.89 million (741.7%) GGY Apr09-Mar10 £632.22 million – GGY Apr18-Mar19 £5,321.11 million The current disruption to the UK could impact some of our statistics, and accuracy may be affected due to lower sample sizes, or a reduced ability to offer demographic, regional or other breakdowns. In some cases, the production of some data series may need to be suspended and we may find advantages in using other data sources. Online gambling yields in the United Kingdom (UK) 2009-2013, by segment Gross gambling yield of on course betting by sector Great Britain 2018-2019 Gross gambling yield gaming machines in Great 0.5% of the UK’s adult population are problem gamblers. 15% of online gamblers have been gambling in the workplace in the past four weeks. 3.1% of gamblers have bet more than they can afford to lose. Gambling addiction is estimated to cost the UK between £260 million and £1.2 billion per year.
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