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Prostitution in Dubai: Places to avoid in Dubai

Dubai Expat Blog

Dubai is a progressive city, ever expanding and innovating. The liberal visa policies and relaxed rules in Dubai attract huge numbers of people every month who arrive in the Emirate for work, visit and fun. Some have different (and often lewd) definitions of these terms than others. There is a dark side to Dubai about which every resident expat, and visitor should know and avoid as much as possible. Once such aspect is prostitution in Dubai.

Although UAE is an islamic country and prostitution, fornication and adultery are illegal and punishable crimes here. However, the free-market approach has created lacunas and loopholes that are exploited by those involve in this “profession”. Prostitution in Dubai is alive and kicking, as strongly as the desert sun that shines in the day.

Prostitutes in Dubai: The Nigerians

There was a report published in Nigerian Political Economist that narrated accounts of Nigerian women working as prostitutes in Dubai. These women, some in their twenties and thirties flock to Dubai with tourist visa, operate as commercial sex workers for months and use the money to buy goods for sale in Nigeria. The report mentioned Astraf Hotel and Rhami Hotel in Deira as part of Dubai sex market where Nigerian women work as commercial sex workers. Their clients are mainly visiting African men including Nigerians, Asians and Arabs.

Nigerian women for reasons bordering on hardship at home have found a lucrative trade in the Dubai sex market. Nigerian women flood Dubai to prostitute. It is called ‘Dubai Runs’. They fly into Dubai, operate as commercial sex workers for a month or two, use the proceeds from their ‘trade’ to buy goods before returning to the Nigeria.

Places to avoid in Dubai

Here is a list of hotels and places that are major contributor to prostitution in Dubai. These places must be avoided especially if you are here with your family. (list from GrapeShisha.com)

Cyclone Club (Al Nasar Leisureland) – also known as United Nations of Prostitution! York Hotel (upstairs bar) Imperial Suites Hotel (Stayin Alive) Panorama Hotel (Jockeys Bar) Regal Plaza Hotel Sea View Hotel (Filipino Bar) Astoria Hotel (TGIT) Hyatt Regency Deira Hotel Hotels near Al Nasr Square Hotels near the Fish roundabout in Deira MarMar Hotel on Yousef Baker Road Radison Blu (Kubu International) Moscow Hotel (Red Square Club) Metropolitan Hotel (Rattlesnakes) Hyatt Regency (Premier Bar)

There are certain massage parlours in Dubai that are also used for prostitution.

While researching for this topic, I saw this hotel coming up in Google search results for the phrase prostitutes in Dubai. Not sure if it is a case of ambitious keywords to target customers or the hotel is involved in the business.

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Feminists have been attacking politicians or opponents with buckets of excrements without any or minimal judiciary consequences. Let's turn this game around and dowse feminists with buckets of excrements. Let's see what happens.

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Butea Superba and Its Ability to Influence Testosterone Production in the Body

In the world of testosterone boosting supplements, Butea superba is one that may be commonly found within many supplement products. For men over the age of 25, they will begin to experience a decline in testosterone production, as a natural part of aging.

Testosterone is responsible for many male characteristics, including increased muscle mass, a deep voice, body hair, and sexual drive. When testosterone production begins to decline, it can be more difficult to get through a workout, add muscle, and even maintain the muscle that was developed over years.

It may also be difficult for an older male to become sexually aroused or remain at peak sexual performance for a longer duration of time.

That leads many men to seek out various supplements to help either increase the production of testosterone in their body or free up certain testosterone levels.

A Word about Free Testosterone

Free testosterone essentially refers to any testosterone that is not bound to either SHBG (Sex Hormone Binding Globulin) or the protein albumin. When testosterone is bound, it doesn’t have the same ability to help boost muscle strength or even provide an increase in stamina or libido.

Bound testosterone is basically being held by the body for use at a later time. This could be during a workout, a particular fight or flight response that becomes necessary, or some other purpose, but is not free to be used to help increase muscle or get through a difficult workout.

What is Butea Superba?

Butea superba is one of only two known species of the butea genus of plants. It is indigenous to Thailand but has also been found to grow in India and Burma.

Four many centuries, it has been claimed to be an aphrodisiac of sorts. It has gained a great deal of attention during the past several decades in Western societies as an effective solution or treatment for erectile dysfunction.

Only recently have research studies been conducted on Butea superba to determine its influence on testosterone levels and even safety. There are numerous products that rely on Butea superba, and it’s important to understand whether or not it’s actually effective at helping to increase testosterone levels in the body or even help free up testosterone.

We found three research studies the specifically tested Butea superba and measured testosterone levels on subjects, but two of them were conducted on male Wistar rats.

Study #1:

The first study we looked at was conducted in 2012 by Chaiyasit and Wiwnaitkit at Mahidol Nutrition Society, Mahidol University, Thailand. It was a single case study on human subjects. That alone highlights the significant problem with this particular research study, but due to the low level of research conducted on this ingredient, it’s important to include here.

The researchers found an increase in dihydrotestosterone levels for the one human male subject that took Butea superba on a regular basis. What is interesting to note is that the researchers with this study had the subject stop taking Butea superba and after a week the subject reported feeling no increase in sexual drive and dihydrotestosterone levels had decreased to what is considered normal.

While only conducted on one subject, it does highlight a potential ability for Butea superba to help boost testosterone levels for human male subjects.

Study #2:

The second research study we looked at was conducted in 2012 by Malaivijitnond, Ketsuwan, et al. at the Department of Biology, Chulalongkorn University, Bangkok, Thailand. These researchers were looking at the impact of luteinizing hormone reduction on male potency when taking the Butea superba herb.

They conducted their study on five different groups of male Wistar rats. They provided the control group a placebo and the test groups each received 0, 10, 50, and 250 mg/kg body weight of Butea superba in distilled water. They did this over a 30 day treatment period.

The researchers did not find any change in serum testosterone levels or luteinizing hormone levels. They actually found a significant reduction in serum luteinizing hormone levels for those test subject rats that had received 50 mg/kg body weight and 200 mg/kg body weight of Butea superba extract. The researchers found that Butea superba requires androgens testosterone to be able to work synergistically to stimulate the sex organ of intact animals.

Study #3:

The final study we looked at was conducted in 2008 by Cherdshewasart, Bhuntaky, et al. at the Department of Biology, Faculty of Science, Chulalongkorn University, Patumwan, Bangkok, Thailand. These researchers were looking to measure the androgen destruction and toxicity tests of Butea superba commonly used to treat erectile dysfunction.

The test subject male Wistar rats received either 0, 10, 100, 150, or 200 mg/kg body weight of Butea superba powder per day in 0.7 mL distilled water. They conducted this study over 90 consecutive days.

The researchers found a decrease in testosterone in rats that were treated with 150 and 200 mg/kg dosages for body weight.

They concluded that there was a significant risk of overdose consumption problems with Butea superba. In other words, taking too much of Butea superba could actually have a reverse impact on testosterone production, thus resulting in lower testosterone levels.

Conclusion

It’s important to note that while some of the research that was conducted on Butea superba found an increase in testosterone levels, the two studies conducted on male Wistar rats found that elevated dosage levels of Butea superba could actually negatively impact testosterone levels and luteinizing hormone levels in male subjects.

The overall conclusion is that Butea superba is certainly effective at increasing dihydrotestosterone and testosterone levels in the body, but to make sure not to use an elevated dosage is that can have negative repercussions.

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Standing up for Saudi Arabia’s ‘Prostitutes’

Huffington Post

Last Sunday, history was made in Saudi Arabia when the recently sworn-in Shura Council, the country’s consultative assembly, held its first session with 30 women appointees participating for the first time.

Thanks to a Royal Decree issued by King Abdullah bin Abdulaziz earlier this year, room has now been permanently made for women to take part in advising the government on issues that matter.

As such, Saudi Arabia’s Shura Council will never again be a “men-only” club.

While most Saudis rejoiced this historic accomplishment; the implementation of the decision was received with the contempt of some who resorted to micro-blogging site Twitter to publicly insult the recently-appointed women Shura members.

Derogatory terms such as “prostitutes” and “the filth of society” were used to describe Saudi Arabia’s finest female academics and technocrats.

These terms are already deemed foul and derogatory when coming from the man on the street. But those behind the appalling statements were Islamic teachers and Sheikhs; a slash of irony unleashed from the men who should otherwise be preaching tolerance, respect and compassion.

‘The Filth of Society’

Whilst one doesn’t expect all members society to behave in a similar manner, nor to necessarily respect the achievements of Saudi women; the idea here is that this shouldn’t legitimize the public defamation and insults we have witnessed.

Among the “tweeps” who resorted to insults was member of the Islamic Ministry for Da’wah, Guidance and Endowments, Ahmed al-Abdelqader.

“They thought they can mock the mufti by giving these ‘prostitutes’ legitimacy to be in power,” tweeted al-Abdelqader.

Following angry reactions by Twitter users whom objected the cleric’s foul language, Al-Abdelqader said: “We have heard and read many insults against (God) as well as mockery against the prophet, prayer be upon him, and none of those defending (these female) members was angered.”

Earlier last week, another controversial Saudi cleric also attacked the decision to appoint female members to the Council.

“Corrupt beginnings lead to corrupt results,” tweeted Sheikh Nasser al-Omar warning more of what he described as “Westernization.”

For his part, Dr. Saleh al-Sugair, a former teaching assistant at King Saud University slammed the assignment of female members at the council and tweeted: “The insolent (women) wearing make-up at the Shura Council represent the society? God, no. They are the filth of society.”

This wasn’t the first controversial statement by al-Sugair, who is not a cleric but a medical doctor known for extreme religious views.

Last year, he called for a complete separation in medical colleges between male students and female students.

Sharia is against defamation

Last summer, two courageous young female athletes by the names of Wojdan Shaherkani and Sarah Attar agreed to become Saudi Arabia’s first ever female participants at the Olympics.

The decision, which was reached at the eleventh hour, saved Saudi Arabia from being excluded completely from the London 2012 Olympics.

At the time, the International Olympic Committee (IOC) had insisted that all participating countries needed to have female representation; and even though Sarah and Wojdan knew they lacked the experience to win on the international level, they still agreed to take part and respond to the call of duty.

Instead of praise, the two young athletes received their share of derogatory terms, in a very similar manner to what the ladies of Shura Council had to endure last week.

Wojdan’s father (and her Judo instructor) had pledged to take those who have questioned the morality of his 16-year old daughter and insulted her to court.

As a professional and aspiring Judo player, Wojdan is likely to fight many battles for the rest of her life; however, of all those battles, this legal one has to be the most important, and it must be won.

Of course, the battle will be tough as it will require a much clearer and much stricter implementation of defamation and libel laws, probably under a specialized committee.

Whilst one doesn’t expect all members society to behave in a similar manner, nor to necessarily respect the achievements of Saudi women; the idea here is that this shouldn’t legitimize the public defamation and insults we have witnessed.

Women at the Shura Council should study this matter and make appropriate suggestions to the government to criminalize and penalize such libel acts.

What will definitely help such a move is that Shariah law is renowned for prohibiting defamation; and it doesn’t make exceptions if the perpetrator is a cleric or not.

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The world is full of multimillionaires who can't handle money. Because, if you have money, live in a Third World country where you can have all the women you want.

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Men risk their lives in wars so women can enjoy societies where they can pursue feminist goals, such as punishing men for sexist language.

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Company Releases 'Child Love Dolls' to Stop Pedophiles Rumor: A company has released 'child love dolls' to provide a safe sexual outlet for pedophiles.

Snopes

Could you look into the validity of a supposed new company that will be marketing “love dolls” for pedophiles?

ORIGINS: On 13 April 2015, the entertainment web site Celebtricity published a hoax article reporting that a former sexual molestation victim had started a company to produce lifelike male and female “child love dolls” that pedophiles could have sexual relations with in place of molesting real children:

Buck Dobson knows what it is like to suffer at the hands of pedophile. He was repeatedly molested at age 10 by his 19-year-old-sister and says the scars have never healed. However, the abuse inspired Dobson to spend most of his adult life working to cure pedophilia. For years, Dobson tried to rehabilitate pedophiles within the Colorado prison system and through Christian outreach programs, but Dobson said his efforts failed.

“Look, you can’t change a pedophile’s sexual-orientation, and that’s what it is, an orientation, any more than you can a homo or heterosexual’s,# Dobson told Christian Family Daily. #You can try to get a pedophile to refrain from touching kids — and that sometimes works — but these people desire children and that desire is deep inside their genes. So why try to fix something unfixable?”

Instead, Dobson is starting a company that will create and market life-like male and female child and baby love dolls that pedophiles can molest and have sexual relations with.

“#These dolls will feel and smell just like real children and have all the naughty parts,”# Dobson said. “#Pedophiles are gonna love them.”

Unlike many “satire” sites operating on the Internet, Celebtricity occasionally posts real news stories in addition to its fake news pieces in an effort to confuse readers. That strategy seems to have worked, as many readers have shared this “news” about “love dolls” for pedophiles as if it were a factual account. Nonetheless, Celebtricity‘s disclaimer reveals the nature of that site:

Celebtricity.com is a combination of real shocking news and satirical entertainment to keep its visitors in a state of disbelief.

In January 2016, life appeared to imitate fake news, as stories emerged that a company is, indeed, producing dolls similar to the ones previously described. Shin Takagi owns Trottla, a company that produces anatomically-correct child sex dolls that he says are manufactured in order to help pedophiles control their urges. “I am helping people express their desires, legally and ethically,” Takagi told The Atlantic.

“We should accept that there is no way to change someone’s fetishes…. It’s not worth living if you have to live with repressed desire.”

However, the Celebtricity entry clearly falls into the category of “satire” rather than “real shocking news”: In addition to the fact that the article is missing key information (such as the name of the company putatively planning to release these “love dolls”), the image accompanying the article was swiped from the web site of French artist Lauren Curet, who creates detailed miniature child dolls from polymer clay as artworks rather than as sexual playmates for pedophiles.

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Feminism is about the domestication of men. Feminism wants to force men into being docile, so women have all sexual rights, at no risk. That will be all the less feasible the more violence there is in a society.

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Why Men Put Needles In Their Balls Even Though It's DANGEROUS

Women are not alone when it comes to trying out ridiculous medical procedures all in the name of beauty.

There's a new guys-only trend rising in cosmetic surgery and it's guaranteed to make you cringe. Men are having Botox injected into their scrotums to reduce sweating and the appearace of wrinkles.

I do not even have a penis and the very idea of sticking a needle full of botulism toxin into my ballsack has me wincing in a very real way.

It's easy as a woman to feel smug about this rising trend in dudes tending to their penises and scrotums with high-end, needless, medical procedures. It feels like the shoe is finally on the other foot. For years we've been injecting ourselves, not to mention peeling and lifting and toning and waxing, why shouldn't men feel exactly the same sort of pressure to look and feel forever beautiful and forever young?

But because I am a decent human being I cannot truly revel in the burning ashes of the male ego.

Instead I've got to be logical and say, "Guys, don't get botox in your balls, your balls are near your penis, it's not necessary and actually really, really high risk."

For one thing, balls are SUPPOSED to be wrinkly. That's the way they are designed. The muscles that give the scrotum that wrinkly appearance are called the Dartos muscles. They are responsible for keeping the testicles mobile within the scrotal sack.

The testicles need to be mobile because the sperm they house is very, very sensitive. When the air gets too cold, the Dartos muscles contract, lifting the testicles up closer to the body for warmth. When it's too hot out, they retract, cooling off the testicles before the sperm can boil to death.

Botox in your scrotum in a best case scenario stops your balls from doing something that they need to do.

I thought being super fertile was one of the cliched ways men took pride in their masculinity? If that's the case why undergo a procedure that, even if performed "correctly" could hamper their ability to get a woman knocked up?

The other reason men are getting the procedure done in droves is because of ball sweat. I hate to break it to you dudes, but your penis and your balls NEED to sweat. The shaft of the penis and the scrotum are notoriously sweaty. Why? For the very same reason that the Dartos muscles exist inside the scrotum. Sweating helps regulate temperature which in turn keeps your sperm from slow cooking in the crock pot that is your junk.

Great, now I've ruined slow cooking for myself, thanks for NOTHING, Botox.

Most doctors advise against getting "scrotox", which makes sense given everything we've covered above, but human beings love to change things about themselves, even if there's a biological reason for the design in question.

I don't want you to think I'm a hypocrite. I'm only 33, and outside of getting some questionable moles removed, I've yet to have any plastic surgery. But I'm not ruling it out for myself. Beauty and self-perception are constantly evolving, and if that means one day I want to get a brow lift because I think it will make me feel happy, I will get that brow lift.

By the same token, I understand why a man might want to get "scrotox". It's for the same reason some women get breast lifts or a tummy tuck: they aren't feeling as good about themselves as they once did and they know that this procedure is something that could help change that.

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On some men, butea superba extract has a profound effect after just few dosages. It can kickstart testosterone tone for weeks on end. Users should watch out for signs of testosterone overdrive such as deep heartbeat with the slightest sexual thought.

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Botox Could Be the New Penis Wonder Drug

As long as guys are cool with having a needle stuck in their junk.

Most people think of Botox as a cosmetic drug that does just one thing—it temporarily reduces the appearance of fine lines and wrinkles on the face by paralyzing the underlying muscles. As it turns out, Botox can do so much more: In recent years, doctors have found that it can be useful for treating a wide range of medical conditions, including chronic migraine headaches, an overactive bladder, excessive sweating, and even crossed eyes.

But that's not all. Botox, it turns out, also has the potential to help men who have concerns about the appearance and function of their penises. Here are three surprising things Botox can do down there.

It can increase flaccid penis size.

A recent survey of more than 4,000 US men found that guys' biggest complaint about their genitals was the length of their flaccid (non-erect) penises. More than one-quarter of respondents wanted theirs to be longer.

For a man who wishes he was more of a "shower," there aren't a whole lot of options on the market, short of expensive and risky surgical procedures and stretching devices that need to be worn several hours per day for months on end. Botox, however, could change that.

In a 2009 study, researchers used Botox to try and help guys who had a "hyperactive retraction reflex." In other words, these were men who experienced a lot more "shrinkage" (in the words of George Costanza) than others. Doctors made four injections around the base of the penis, with the goal of paralyzing the muscles responsible for the shrinkage reflex, known as the tunica dartos. And it worked.

Average flaccid size was about half an inch larger after the injections, and the guys didn't shrink as much in response to cold temperature. Most participants were happy with the outcome. However, it's important to note that erect size didn't change, and the effects were temporary—they lasted up to six months. So this isn't a one-shot deal—it's something you'd need to do at least a couple of times per year, just like if you were treating forehead wrinkles.

It might help guys last longer in bed.

Premature ejaculation is the most common sexual problem reported by men. There are tons of treatments out there for it already, including "delay sprays," Kegel exercises, and behavioral methods like the stop-start technique, but Botox might be another viable option in the near future.

In a 2014 study, researchers injected Botox into the bulbospongious muscle of male rats. This muscle sits at the base of the penis (see here) and is involved in ejaculation. Using Botox to paralyze this muscle can make sex last longer: For rats that received a placebo shot, their average time to ejaculation was six and a half minutes, compared to ten minutes for those that got a full dose of the drug.

There's a clinical trial underway right now to see if it works just as well in humans. We should know the results later this year, which will also tell us whether or not repeat doses are required, or if a single treatment might be enough for guys to learn more ejaculatory control.

It could help treat erectile dysfunction, too.

A new paper published in The Journal of Sexual Medicine argues that Botox could be a "game changer" when it comes to treating erectile dysfunction (ED). The thought here is that Botox could be used to paralyze the smooth muscles inside the erectile chambers of the penis. By relaxing these muscles, blood should be able to flow into the penis more easily.

A small study conducted in Egypt that was reported last year provided some initial support for this idea: Men with ED who received a Botox injection demonstrated improvements in penile blood flow. One patient, however, experienced priapism afterward—a prolonged erection that wouldn't go away on its own. This tells us that dosage is going to be very important: Too much muscle relaxation isn't a good thing.

Larger clinical trials should be underway soon, but in the meantime, it's important to highlight that any effects are going to be temporary and that once the Botox wears off, erectile difficulties will return because those muscles will start contracting and impeding blood flow again. Although it's not a permanent fix, Botox could be more appealing to some guys than Viagra due to convenience: Rather than popping a pill every time they want to have sex, they could just get a couple of shots per year.

While scientists will undoubtedly continue to explore these and other effects of Botox on the penis, this doesn't necessarily mean patient demand will follow. Indeed, we don't know yet how many men are actually going to take advantage of these discoveries in the future. After all, if you want to experience any of the benefits of "bonetox," you have to be cool with someone sticking a needle in your junk.

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Arson is the terrorism of the future. Attackers can buy their weapon at any gasoline station, and risk just 2 years in prison.

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You probably have to look at imagery of death and dying regularly to stay focused on what really counts in life: great sex before you are gone anyway.

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Anesthesia Awareness

Duke University Scool of Medicine Duke Anesthesiology

When the movie “Awake” came out in theaters it sparked much controversy throughout the country about the condition also known as anesthesia awareness. Following the release of the movie, Larry King Live did a special about this issue, in which King interviewed physicians and patients who have suffered from awareness. In response to the recent influx in publicity over the issue, the DREAM Campaign has taken the initiative to interview Dr. Tong Joo (TJ) Gan, who sheds light on many concerns that patients have when considering a surgical procedure as well as the misconceptions about anesthesiology in general. With so much focus on awareness and the negative impacts of anesthesia, it is important that the public be properly informed. Awareness can be a highly unpleasant experience, but most times the alternative is a surgery with negative outcomes or even worse, death.

There are about 100 to 150 reported cases of anesthesia awareness per year in the United States. It is very difficult to get an exact figure because it is under reported. Dr. Gan shared with us a case in which a patient of his experienced anesthesia awareness. The patient had come to the Emergency Room with a gunshot wound to the abdomen. He was suffering from massive blood loss and had very faint blood pressure so the anesthesiologist had to administer a safe dosage of anesthesia that would not hinder the overall well being of the patient as well as the blood pressure. When questioned post-operatively, the patient reported that he could hear voices during a brief period in surgery.

Hearing is said to be the last sense to go and the first to return under general anesthesia. As in the case of Dr. Gan’s patient, the modifications that had to be made because of low blood pressure caused the patient to become slightly aware and that is why he was able to hear briefly during his operation. “He did not suffer from any consequences after that and in fact, he thought that it was part of the operation,” said Dr. Gan.

When asked the common question, how can a person feel pain when they are paralyzed, Dr. Gan discussed the three areas of anesthesia; paralysis which paralyzes the muscles, analgesic which block pain signals to the brain, and anesthetic which puts the person to sleep so that they do not remember anything. For this reason, a person can be physically paralyzed but they may still feel pain. The human body does have natural responses to pain such as sweating, increased blood pressure and movement which may indicate to the anesthesia care provider that they are not fully anesthetized.

New technology allows anesthesiologists to measure the brain waves of a patient even while they are under anesthesia. “By using specific monitors, one can tell how deep a person is in anesthesia,” says Dr. Gan, “It is a bit like an iceberg; if it is below the water, it is very difficult to know how deep the iceberg is, and the monitor tells you what the depth of anesthesia is even when the patient is asleep.” The Bi-spectral Index Monitor, or BIS monitor is an example of such a device. Brainwaves are measured on a range of numbers from 0 to 100 in which 0 equates no brain activity and 100 is the mental state of a person when fully awake. During general anesthesia, brainwaves are measured between 40 and 60. If the BIS monitor measures activity above 70, there is a very good chance that the patient may not be fully anesthetized.

Dr. Gan mentions several fascinating facts throughout the interview one being that genetic factors can influence the way a patient reacts to anesthesia. Studies have shown that women tend to wake up about 10 minutes sooner than men when the anesthesia is cut off. This means that women need more anesthesia in order to produce the same effect. Redheads are also said to need more as well.

The revolutionary research that is being done by researchers like Dr. Gan is vital to prevent cases of unpleasant experiences and side effects. “One of the most effective ways to try and prevent this problem is to raise awareness of this problem, no pun intended,” Dr. Gan explains, “So we educate our staff, anesthesiologists and anesthesia care providers to let them know that this problem does exist and therefore it is important to take steps as well as understand the patient to try and prevent it.” He also mentions that there are mandatory educational modules that every anesthesia care provider must take. These modules go through various aspects of educational awareness such as the incidents of awareness, the scenarios where awareness may happen, the drugs or drug combinations that would reduce the incidents of awareness as well as monitoring the inter-operative awareness.

The Department of Anesthesiology is committed to find as many ways possible to provide the best patient care. Dr. Gan’s research in particular focuses on steps that could alleviate patients from the common unpleasant side effects of anesthesia and surgery by improving patient outcomes during the perioperative (before, during and after surgery) period including anesthesia awareness, pain, nausea and vomiting, and bowel dysfunction through the use of drug and non-drug method, such as acupuncture. Our hope is that through listening to this interview, people will become educated about the issue and in turn they will be relieved of any anxiety they may face about being under anesthesia.

Dr. Gan is a professor and devoted researcher here at Duke, whose interests include Anesthetic-related Clinical Pharmacology, Inter-operative Awareness and Post-Operative Pain, Nausea and Vomiting, and using Acupuncture. He came to Duke as a visiting associate and fellow in 1993 is now serving as both professor and Vice Chairman of Clinical Research. Dr. Gan is also known for his research on the Bi-spectral Index (BIS) Monitor.

Patient Awareness Under General Anesthesia Lifeline to Modern Medicine

What is patient awareness under general anesthesia? Awareness under general anesthesia is a rare condition that occurs when surgical patients can recall their surroundings or an event—sometimes even pain—related to their surgery while they were under general anesthesia.

When using other kinds of anesthesia, such as local, sedation or regional anesthesia, it is expected that patients will have some recollection of the procedure.

Studies are not conclusive on the frequency of awareness under general anesthesia, but even one case is important to anesthesia professionals (anesthesiologists and certified registered nurse anesthetists), who recognize that this can be a distressing or traumatic experience for the patient.

When awareness during general anesthesia does occur, it is usually just prior to the anesthetic completely taking effect or as the patient is emerging from anesthesia. In very few instances, it may occur during the surgery itself. Despite the rarity of awareness, members of the American Society of Anesthesiologists (ASA) and the American Association of Nurse Anesthetists (AANA) want you to know about this possibility. These organizations have been studying this issue and are in the process of evaluating the effectiveness of various technologies and techniques to decrease the likelihood of this occurring.

Why does it happen? In some high-risk surgeries such as trauma, cardiac surgery and emergency cesarean delivery, or in situations involving patients whose condition is unstable, using a deep anesthetic may not be in the best interest of the patient. In these and other critical or emergency situations, awareness may not be completely avoidable. While the safety of anesthesia has increased markedly over the last 20 years, people may react differently to the same level or type of anesthesia. Sometimes different medications can mask important signs that anesthesia professionals monitor to help determine the depth of anesthesia. In other rare instances, technical failure or human error may contribute to unexpected episodes of awareness. The ultimate goal is always to protect the life of the patient and to make the patient as comfortable as possible. That is why it is important to have highly trained anesthesia professionals involved in your surgery.

How can it be avoided? Before surgery, patients should meet with their anesthesia professional to discuss anesthesia options. Should there be concerns regarding awareness, this is an ideal time to express them and to ask questions. Patients should share with their anesthesia professional any problems they may have experienced with previous anesthetics, and also discuss any prescription medications or over-the-counter medications they are taking.

As always, your anesthesia professional will guide you safely through your surgery by relying on his or her clinical experience, training and judgment combined with proven technology.

What You Should Know About Patient Awareness Under General Anesthesia It is quite rare. When it does occur, it is often fleeting and not traumatic to the patient. Patients experiencing awareness usually do not feel any pain. Some patients may experience a feeling of pressure. Awareness can range from brief, hazy recollections to some specific awareness of your surroundings during surgery. Patients who dream during surgery, or who have some perception of their surroundings before or after surgery, may think they have experienced awareness. Such a sensation or memory does not necessarily represent actual awareness during surgery. Experts in the field of anesthesiology are actively studying this condition and are seeking the most effective ways to prevent it. Awareness can occur in high-risk surgeries such as trauma and cardiac surgery in which the patient’s condition may not allow for a deep anesthetic to be given. In those instances, the anesthesia professional will weigh the potential for awareness against the need to guard the patient’s life or safety. The same is true during a cesarean section, particularly if it is an emergency and a deep anesthetic is not best for the mother or child.

It has been shown that early counseling after an episode of awareness can help to lessen feelings of confusion, stress or trauma associated with the experience. Researchers in anesthesiology have spearheaded developments in technology that have dramatically improved patient safety and comfort during surgery over the last 20 years. A highly trained anesthesia professional should be involved in your surgery. No technology can replace this expertise. New brain-wave monitoring devices currently being tested may prove to be helpful in reducing the risk of awareness, but they need to undergo the same rigorous scientific review process that has led to wide adoption of other medical technologies. Patients should talk with their anesthesia professional before surgery to discuss all of their concerns, including the remote possibility of awareness. These professionals work to ensure the best possible care of patients in the operating room.

Patient awareness happens very infrequently. This remote possibility should not deter you from having needed surgery. Your anesthesia professional can help you to feel comfortable and informed about your upcoming experience with anesthesia.

What does the future hold? As patient advocates, anesthesia professionals are working hard to reduce the likelihood of awareness under general anesthesia. Depending upon the type of surgery, these experts have an array of proven technologies that can be used to monitor various vital signs of the surgical patient. Extensive research is under way to develop and study new technologies, such as brain-wave monitoring, that may lessen the risk of awareness. At the present time, none of these new technologies has been perfected.

Remember—no monitoring device can replace the judgment and skill of an anesthesia professional who has years of training and clinical experience. Working together, you and your anesthesia professional can make your anesthetic experience as safe and comfortable as possible.

What should I do if I think I have experienced awareness? The American Society of Anesthesiologists urges you to talk with your anesthesia professional, who can explain to you the events that took place in the operating room at any stage of your surgery and why you might have been aware at certain times. It is important to note that a variety of anesthetic agents is often used, some of which may create false memories or no memory at all of the various events surrounding surgery. If you have distinct recollections of your surgery and want to discuss them, your anesthesia professional can help you or refer you to a counselor or to other appropriate resources.

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Feminism in Europe makes second-generation male Muslim immigrants suicide bombers. Only the patriarchy as a social and political system can achieve justice.

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I had vagina therapy with a vagina physiotherapist

I thought the recovery from my child’s birth would be easier than the birth itself. I was wrong.

My baby was born by scalpel – an episiotomy. Episiotomy, also known as perineotomy, is described as a surgical incision of the perineum and the posterior vaginal wall generally done by a midwife or obstetrician during second stage of labor to quickly enlarge the opening for the baby to pass through.

I cannot put into words what it was actually like.

She was perfect, although a little bloody. I expected to be back on my feet quickly. But I was wrong, so very wrong.

Life with a newborn is not easy, even less so when you have another child or two that also needs your attention. It is even harder when you are in excruciating pain.

The constant pain was debilitating. I was unable to walk some days and was often forced to look after my two children from the floor where I crawled everywhere. When my husband came home I was an emotional and physical wreck. I was often in so much pain I had to dose myself up on medication and lay face down on the carpet next to the blanket on the floor that contained a days worth of spit up.

Even thinking about sex was hard, it was eight weeks before we gave it a go for the first time. My husband was understanding, sympathetic about the lack of sex during the first few months, and lets be honest – also very tired from helping me with the night shift. But I’m sure it was also frustrating for him.

After eight weeks I was physically healed, but mentally… not so much. It was not really painful during sex, but it sure was afterwards.

I began to become convinced that there was something seriously wrong with my vagina.

I went to the doctor and pleaded with her to try and fix me. She gave my vagina the once over and said that everything looked fine, but said that there may be some nerve damage and she would send me off to get X-rays just in case it was a broken pubic bone.

Well hell, this must be it! I thought.

My vagina is broken! Six bloody months of walking around with a broken bloody vagina. It made sense!

Then the X-ray came back all clear. Although I was convinced that they must have done it wrong, I had to accept I didn’t have a broken vagina.

There was only one more step to take and the doctor suggested a physiotherapist…. for my vagina.

So off I went to a vagina physiotherapist. To have vagina therapy.

Did you even know this was an actual job? I sure didn’t. And as I sat in the hospital waiting room looking at all of the other patients quietly waiting in wheelchairs, sitting with helpers – post car crashes and work injuries – I worried about what they might be thinking of me. Where was her injury? Why wasn’t she limping enough to notice?

I walked into the little room accompanied by the physiotherapist, an attractive smart blonde woman with shiny black flats. I really wanted to ask her right off the bat what her deal was, why vaginas? Why not feet? But I saved that for the second visit two months later when she told me that she just wanted to help women and their sexual health. She sounded legit.

The exam was similar to a doctors exam but without as many contraptions, she asked me to do a kegel (where you tighten your vagina). I did, and she looked at me quite surprised, “Hmmmmmm” she said, with her finger still wriggling around inside me.

“That’s about as strong as I have felt…” she kept wiggling. “… And the left side is VERY tight!”

Post-exam she sat me down and told me what the problem was. I had a tight vagina. Actually she used the words “I think you have a condition known as vaginismus which is a genito-pelvic pain disorder. A condition that affects a woman’s ability to engage in vaginal penetration, where your pelvic floor is tight and can spasm.”

But all I heard was “TIGHT VAGINA”.

And you know what? I smiled, looked up to the ceiling nodded my head and laughed.

This whole time I’m walking around in constant pain thinking I had broken myself when in reality it was my muscles tightening up so much on the left side that the pain radiated down my legs.

She gave me a print out with information about vaginismus. On the flip side of the page was some yoga, breathing and visualisation exercises.

I’m not really the most serious person. The printout had a diagram of a stick figure lady, legs up in the air, visualising her vagina relaxing. To this day, it’s quite possibly the most hilarious thing I have ever seen.

But I did all of the exercises. I breathed calmly like you wouldn’t believe. I visualised the hell out of my vagina getting all loose.

And it worked!

The pain subsided and I could walk around like a normal person without feeling like someone had shoved a porcupine up there.

The problem with any disorder that is caused in part by anxiety is that you are sometimes the only one that is in charge of your own recovery.

When I was diagnosed my physiotherapist had said exactly that to me:

“I have good news and bad news. The good news is that you are in charge of your own recovery. The bad news is that you are in charge of your own recovery.” Those words have stuck with me.

You can be helped along by medication and pain relief – both of which I have definitely taken. But ultimately it’s up to you. And it’s daunting to be the only one that can really fix you, but it is also empowering.

You don’t have to have a traumatic birth for you to be traumatised in some way, you don’t have to have a difficult birth in order to feel it was difficult for you. Birth is such a different experience for us all and our own experience of it and how we deal with it afterwards is unique.

Vaginismus is often triggered by childbirth but it can also be something that was always there, something that can develop in your teenage years. It can stop women from ever having sex or it can mean having painful sex frequently.

If you think you might have something similar please see your doctor as it could be a symptom of anxiety or something else.

Your sexual health is just as important as anything else in your life. I never thought I’d have vagina therapy but I’m very glad I did.

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Medical records released. Stalin had a micropenis.

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