TMI: Erectile dysfunction testing in the sleep laboratory

Dr. Urspo, on his blog, recently mentioned a couple of objects found in his office desk drawer which may have been used as a method of explaining how to use them. The objects were a cock ring and a condom. This triggered a memory of erectile dysfunction testing as a part of sleep disorders testing. In the old days before Viagra and Cialis, Medicare, Workmen’s Compensation, and some other insurance companies would pay for devices to treat male impotence. However, they needed to establish that the man was not capable of getting an erection.

All males from infancy to old age get penile erections during REM sleep. If a man has erections during REM sleep, then he should be able to get erections while awake as well. If he can get erections during REM sleep, but could not get erections during sexual arousal, it was considered to be a psychological problem. However, if he did not get erections during REM sleep, the lack of erections was considered physiological, such as a result of diabetes or injury, etc.

An early method was to use a strip of postage stamps. The denomination of the stamps was of no use and therefore one would use one cent stamps. One would wrap a long enough strip of the stamps around the flaccid penis to connect them at bedtime. No jokes, now, about who would lick the stamps. If the subject had an erection during the night, then the perforations between the stamps would be separated. Otherwise, without an erection, the stamps would be intact as placed the night before. This was a somewhat crude inexpensive test, and therefore better evidence of an erection was needed.

The method of testing erectile ability during REM sleep, was to place mercury strain gauges at the base of the penis, and also just under the glans of the penis. When the penis became erect and engorged with blood, the strain gauges would be stretched, and send a signal to the polysomnograph. The beginning of the erection as the gauges enlarged was known as T–up. Maximal enlargement was known as T–Max, and this was followed by T–down. [T=tumescence] This tracing on the polysomnograph would then be correlated with REM sleep.

Usually during the second REM period, the technologist would hurriedly go into the patient’s room with a Polaroid camera and a buckling device. The patient would be uncovered, a picture would be taken of the erection, and the buckling device would be pressed against the tip of the penis to determine how many grams of pressure would be needed for the penis to buckle. This procedure could be embarrassing for both the patient and the technologist, especially if she were female.

We once had a female tech who said, “I’m not going to touch any of those penises.” She devised a method of getting the strain gauges on the penis, without having to touch the patient. Going to the local adult bookstore, she purchased a dildo, which was molded from the penis of a well-known porn star.
To instruct the patient, she would place the mercury strain gauges on the dildo in their proper locations. Then she would instruct the patient to put the gauges on his own penis in the same way. That method worked very well for her. One day, the hospital administrator was giving a tour to a group of dignitaries. And wouldn't you know it, one of the dignitaries saw the dildo sitting on the shelf, and wanted to know what that was for!

Bucket List versus Accomplishment List

I suppose that I have already accomplished most of the places that I wanted to go with the exception of Australia and New Zealand. I have always thought that it would be great to visit the Great Barrier Reef in Australia. But now that would have to be using a glass bottom boat, because I'm too old to either snorkel or scuba.  

So an accomplishment list might make more sense for this blog, because I have been able to visit many wonderful places in the northern hemisphere. Some of these places are so great that they deserve blog entries of their very own such as my visit to England and my cross country Amtrak train trip. For both of those trips I kept detailed diaries and plan to publish those diaries as posts in this blog.  

I have been to 48 of the 50 United States and therefore too many cities. Most of them would not have appeared on my bucket list. However the following places and cities would have been on my bucket list and I have already visited them: 
  • Oahu and the Big Island in Hawaii 
  • Seattle with the Space Needle and Mount Rainier 
  • San Francisco with its cable cars & Golden Gate Bridge 
  • Las Vegas (although would not have been on my bucket list.)
  • Los Angeles (also not on bucket list)
  • Tucson, Arizona (I would have liked to see more of the Southwest including the Grand Canyon.)
  • New Orleans at Mardi Gras time 
  • Chicago
  • Boston
  • New York City on which I did a recent post 
  • Philadelphia for genealogical research as well as NYC.
  • Washington, DC 
  • Miami Florida, where I lived in Coral Gables  -- so I visited the Everglades and Key West, of course.
  • Orlando, Florida including Disney World
  • I would liked to have followed the Lewis & Clark trail, although I was in Great Falls, when the Lewis & Clark National Historic Trail Interpretive Center was opened and was interviewed for the local paper. I have also visited Lewiston, ID and Clarkston, WA across the river from each other.
  • During my college years, I hiked the Appalachian Trail from Newfound Gap to Davenport Gap two years in a row.
  • Blue Ridge Parkway and Skyline Drive from end to end.
  • Athens, Greece with the Parthenon on the Acropolis 
  • London, England and other parts of England 
  • Taipei, Taiwan
  • Beijing, China and toured the Forbidden City
  • Bangkok, Thailand  and bought Jim Thompson silks
  • Seoul, Korea 
  • Toronto, and Niagara Falls, Canada 
  • Acapulco, Mexico
  • Nassau, Bahamas
  • Port-au-Prince, Haiti to visit dictator Jean Claude ("Baby Doc") Duvalier
See my website for some of these places.

Technology comes of age

For 30 years now, I have been a computer geek utilizing computers both at home and at work. I came across this image on Facebook today which shows you how to use the alternate key along with a numerical command to generate the various symbols.
Because I am such a computer geek I am now starting a new phase in my blogging starting today I will be using Dragon naturally speaking version 12.5. Everything you see here is dictated as I spoke it without correction. The program is doing an amazing job.

Are any of you using speech recognition software? If so, I would like to know your impressions of it. I just cannot believe that this stick Tatian is without errors. Well it finally made a mistake. It did not recognize the word dictation. That’s better.

I have some journals and/or diaries that I would like to put in my blogs. It would be very time-consuming and laborious to type them in manually; therefore, I would like to dictate or that is, read the diaries directly into Microsoft Word. That would be so much faster and easier.

There must be some professionals among you, such as doctors or lawyers, who are already using dictation software. Please comment below how you feel about voice recognition, and how accurate it is for you.


I have always hated snakes.  As far as I am concerned, they are all poisonous!  Forget about the slit or round pupil or the round vs. triangular head. (No, I am talking about two eyes snakes, not one eyed!)

Well, I have finally found a new snake that is wonderful!  And actually it is a COBRA model LX40030.

My master bedroom toilet has been clogged for two days.  Tried the plunger.  No go. Tried a full bottle of Drano and the plunger.  No go.  Added another bottle of Drano to the mix and tried the plunger.  No go.  Let the toilet sit overnight, thinking all that Drano would eventually go to work.  Used the plunger again.  No go.  Now I am too cheap to call the plumber, especially since it is the weekend when I would have to add an emergency charge to the regular high fees.  Internet to the rescue.  Googled toilet snake and voila! the Cobra Household Toilet Auger available at Lowe's came up.  Then spent a whole $8 at Lowe's for the product:
DIY-David reads the instructions (very simple) and goes to work.  Within 5 minutes, there is a sucking sound as the contents of the bowl go down. GO!

Tales of the City . . . NYC!

Over the years, I've had various kinds of experiences in New York City, such as:
  • During the summer when I was 12, my brother and I rode the Silver Meteor from Raleigh to New York City's Penn station, where my aunt and uncle met us. It was mid-morning and they had a fun day planned for us.  First, a boat ride around the entire island of Manhattan.  I only remember seeing one building and that was the United Nations.  
    Why, you ask?  Well, we left Raleigh the evening before, and rode the train all night arriving in the city the next morning.  It was our first time on a train and that was so exciting, that we stayed up all night.  Therefore, the boat ride put me to sleep, and I slept all the way around Manhattan.
  • Several years ago, I was consulting out in the Hamptons on the eastern end of Long Island just before Christmas.  I had a flight out of La Guardia and was coming in on the Long Island Expressway.  Saw a big sign for the exit to JFK airport, but NO sign for La Guardia!  Suddenly, I was at the toll plaza for the midtown tunnel into Manhattan.  At that point, I knew I had gone too far and missed my exit!  I did not have a lot of time to spare before catching my flight, and still had to turn in the rental car.
     So, I pulled into the "manned" toll both on the far right side, and explained my situation.  He said indeed, that I had missed my exit -- two exits back.  So what did he do?  He STOPPED all the toll lanes heading into the city (about six lanes) and led me to the other side to an outbound lane, said that there would be no toll, told me to go to the second exit for La Guardia, and MERRY CHRISTMAS!  I made my flight home with just minutes to spare!
  • In September, 1982, Amtrak had a special deal in which you could travel a section of the country for $75 and the country was divided into 3 sections, which meant I could travel the whole country for $225.  Living in Miami at the time, I decided to do this. (Perhaps a whole blog post later on this fantastic trip.) But this is only about NYC, so I came in from the north into Grand Central Station.  Now since this was a travel the whole USA by train, I did not want to take a taxi to Penn Station, where my next train departed.  So I decided that connecting by subway would be a legitimate "train" connection!  
    The entry from my diary: "The train came to a stop in Grand Central Station and the fumes were noxious as the diesel exhaust from our engine was trapped in the underground cavern.  Above it was easy to get directions for the subway connection. Passing through the turnstile with my token which had cost 75 cents, I boarded the crosstown shuttle which only went one station to Times Square. There I was told to board any downtown train and go only one station stop to 34th street which was Penn Station.  It was very simple and had taken me ten minutes."
  • Before leaving home for a consulting trip to NYC in 1998, I stopped at the ATM to get some cash which was issued to me in the form of brand new twenty dollar bills.  These were the first ones with the portrait off center, but not yet colored.
On this trip I was consulting at St. Lukes Roosevelt Hospital on Amsterdam Avenue at 114th Street.  At lunchtime, I went to a deli on the corner and ordered a sandwich, which I paid for with one of the new twenty dollar bills.  The old man took it and swiped a red marker pen across the face of the bill.  Later, I learned that this was a counterfeit detection measure.  Apparently my bill passed the test.  Later that afternoon, I toured  St. John the Divine Cathedral beside the hospital, the largest gothic cathedral in the U.S. which was begun in 1892 and is often called St. John the Unfinished!  Luckily, I was there before the fire in 2001. ~~ Well, not exactly the story of Jesus and the moneychangers in the church.
  • On another consulting trip, this time to Mt. Sinai Hospital Sleep Lab in the basement of the Guggenheim Pavilion.  The main entrance is on Fifth Avenue across from Central Park up near Harlem.  This training began around 7:00pm and generally when everything was going well, I would leave around 3:00am.  Well, understandably, I was very nervous about leaving the hospital at that hour, especially considering where it was located.  
    I was told that all that I had to do was just go outside the main entrance across from Central Park and there would be a yellow taxi coming along any minute.  Yea, right at 3:00am?  Not only that, but the hospital was locked down at night.  You could exit through the doors, but you could not re-enter.  So being pretty scared, I exited the hospital and about two minutes later -- sure enough, a yellow taxi came by that I waved down!  What a relief!
  • On this particular consulting trip, all of my work was during the daytime which meant that I would have my evenings free (very unusual when teaching sleep disorders), and I was going to be there almost a week.  What a perfect time to catch a couple of Broadway plays and high on my list were Phantom of the Opera and Cats.
On this particular evening, I had finished my work for the day, gone back to the Roosevelt Hotel and changed into an old sweatshirt and jeans to get comfortable, and then wandered out to get some dinner, which I did in a little deli. Already, I had purchased my ticket for Phantom of the Opera, but I still needed a ticket for Cats.  So, I walked around to the Winter Garden Theater to purchase it.  I had only one night left that was available, so I told the lady in the ticket office that I would like a ticket.  She told me that the theater would be "dark" the evening that I requested, but she had a cancellation in row 5 for tonight's performance if I would like it!  So this was going to be my only chance to see Cats --right now looking awful in old comfy clothes.  It was right at 8:00pm and about time for the performance to begin and they were already beginning to lower the lights.  So sheepishly, I found my seat and to my surprise, there was a wide aisle in front of the seats, which looked great to me since I have long legs, and am usually uncomfortable  with my knees in the seat in front of me.  The show started, and cats began running all over the theater auditorium including in the open space in front of me, so I quickly retracted my legs!  
Just a few minutes into the performance, one of the gorgeous male cats came and stood beside me where there was an empty seat and sang "The Naming of the Cats"!  He was only a foot away from me while he sang!  That was the best, most perfect, performance of Cats that I could not even have designed, if I had tried!

  • One final touristy story.  One evening after consulting all day, I walked over to the Empire State Building which was not very far from my hotel.  It was getting late, but I had always wanted to go to the top observation deck.  So I went in and got my ticket for the elevator ride to the top.  It was just before sunset, so the pictures below all reflect that!  Obviously, it was also before 9-11-2001.

Is this the near future?

I don't normally endorse particular products, but I am going to make an exception this time.  A division of Corning Glass is located here in Wilmington, where they make fiber optic cable.  Of course you are aware that fiber optic cable is used in high speed internet transmission, but it is also used in those invasive optical devices that physicians use to peer into your body such as bronchoscopes and colonoscopes.

Here are a couple of YouTube videos from Corning that show how they envision our future.  Some of it is already here, such as in your smart phones.  I enjoyed watching these videos and thought you might like them also:

As an historical aside, PBS is showing "Ancient Computer" on Nova.  It was probably designed and built by Archimedes and his peers around 250 BC.  It was designed to forecast eclipses of the sun and moon, especially the dire "red" eclipse which foretold great battle losses.

Why Is the Sidebar in a Frenzy?

Have you noticed???

The sidebar on all the Blogger blogs has been very jumpy, lately -- just shaking itself up and down.  The main post portion is stable.  It is happening to me on more than one computer, too.  Then I went to a couple of Wordpress blogs and there is no problem there with the sidebars.

Maybe this is what is happening as Google tries migrating Blogger to mobile views (which usually don't include the sidebar -- just the posts).

I know I have astigmatism, but didn't know I have nystagmus as well!

Vangelis: Mythodea — Music for the NASA Mission: 2001 Mars Odyssey

Mythodea — Music for the NASA Mission: 2001 Mars Odyssey is a choral symphony by Greek electronic composer and artist Vangelis. The concert was held in The Temple of Zeus, Athens, Greece on June 28, 2001, and the record was officially released on October 23, 2001, to coincide with the 2001 Mars Odyssey spacecraft entering the orbit of planet Mars. 

Vangelis Papathanasiou on synthesizers and keyboards, 
The London Metropolitan Orchestra augmented by two harpists, 
Sopranos Kathleen Battle and Jessye Norman, 
The chorus of the Greek National Opera, 
The Seistron and Typana percussion ensembles.
Conducted by Blake Neely

Thanks to fellow blogger, AOM, for turning me on to this stirring music!  Two of my favorite operatic stars, Kathleen Battle and Jessye Norman.

Temple of Zeus, Athens - ground level view

Temple of Zeus, Athens - view from the Acropolis