Opinion

Notes of a Sickle Cell Person: Priapism

PRIAPISM

 

Pain can be endured and defeated only if it is embraced. Denied or feared, it grows

Dean Kooontz

The term “priapism” is derived from the name of Priapus, a minor deity of fertility, luck, gardens, and fields in Greek mythology. A famous painting in the entrance to the House of Vettii in Pompeii depicts Priapus with a disproportionately large phallus, leaning against a pillar and weighing his massive penis.

With this said, Priapism in Sickle Cell is a potentially harmful and painful medical condition in which the erect penis or clitoris does not return to its flaccid state, despite the absence of both physical and psychological stimulation, within four hours. Priapism is considered a medical emergency, which should receive proper treatment by a qualified medical practitioner. Early treatment can be beneficial for a functional recovery. It could also mean a persistent, usually painful, erection that lasts for more than four hours and occurs without sexual stimulation. The condition develops when blood in the penis becomes trapped and unable to drain. If the condition is not treated immediately, it can lead to scarring and permanent erectile dysfunction. The condition occurs in 40% of men with sickle cell anemia (Whittington Hospital of Clinical Management Guideline)

It can occur in all age groups, including newborns. However, it usually affects men between the ages of 5 to 10 years and 20 to 50 years.

There are two categories of priapism: low-flow and high-flow.

  • Low-flow: This type of priapism is the result of blood being trapped in the erection chambers. It often occurs without a known cause in men who are otherwise healthy, but also affects men with sickle-cell disease, leukemia (cancer of the blood) or malaria.
  • High-flow: High-flow priapism is more rare than low-flow and usually not painful. It is the result of a ruptured artery from an injury to the penis or the perineum (area between the scrotum and anus), which prevents blood in the penis from circulating normally.

In the cases of stuttering priapism, where the erection typically lasts for less than 4 hours and often will precede the development of an acute priapism, certain measure can be taken at home so as not to inconvenience the family members and others including the patient with the drudgery of frequent visitation to the hospital. These measures include masturbation or sex. When you have sex or masturbate, blood runs through the corpus cavernosa before the penis assumes it flaccid state. And in so doing it could purge the penile cavity of the trapped blood relieving the person of the pain and consequently restoring the flaccid state of the penis. Another form of controlling a stuttering priapism without visitation to the hospital is exercise at the time of the condition. The simple reason behind this is that as the patient walks, strolls, stretches or bends, blood gets supplied to the different parts of the body for such an exercise and hence in so doing the patient gets purged because – and this is just a suggestion borne out of experience– such trapped blood might be “called” upon for use in other parts of the body or might be “redirected” again to complete the initially “assigned” task.

Now sometimes the above strategy might not work and the question that comes up is what to do next if one is not willing to go to the hospital. Sometimes the rather plausible explanation that exercises could summon blood to distribute and redistribute to different parts of the body  and that it should correlate to a flaccid penis falls short when the patient realizes that even after such brisk walks and sometimes too extremes exercises, the erection does not subside.

And here is when I will advise that you invoke the mind-Over-Matter phenomenon. What this simply means is that you can impose the state you wish on your body, and by specificity your erect penis, through the immense power of the mind. You cannot have a flaccid penis as you walk around still lingering with thoughts of how that erection could have proven useful in a sexual encounter with a girl or lady you wish to impress. No. Because as the mind process such thoughts, information is then given to the organs of the body to ready themselves for that sexual encounter in cases the forlorn situation demands. The mind cannot distinguish between your fantasy and your reality. No. It only acts on the information you feed it without any selective bias. Hence the erection never subsides; rather it increases in firmness and strength. What actually needs to be done is to take the mind totally out of this amoral existence, to find a place, one serene one, to settle the mind and engage in a journey of the mind exploiting how you would want to help the world, bring smiles to the faces of the needy, give hope to the hopeless, provide strength to those in weaknesses, satisfy the hungry, be ear to those willing to talk, feet for the ones who cannot walk  and the excitement and fulfillment that you will receive from such acts vividly imagined by the most powerful weapon on the earth – our human brain.

One can also switch on a television, be deeply engrossed in it or go out to feel the beauty and silence of the night. But whatever be the course of action, it must be noted that mobility or movement in the attempt at containing the erection is more readily achievable than taking a stationary position, as with the latter, blood circulation is lower. In the very severe cases where the pain could not be contained by the person even with conventional therapy like the ones discussed above, it should be regarded as a medical emergency with swift action.

Priapism is not any comfortable situation for the Sickle Cell Person. And though the pain is sometimes unbearable, some Sickle Cell Persons feel discomforted in letting in someone on what is happening to him (especially in terms of susceptibility to condition) or her (less in terms of susceptibility to the condition). Many feel shy. And they wallow in that painful house of discomfort, despair and hopelessness. But when detected early on and treated, the Sickle Cell Person would have found that peace and safety he or she earns for from the chill of the night. The specialized urological hospitals for that specialty would conduct various tests to investigate what might be the cause of the condition. Urine toxicology tests could be done to invest if any toxic chemicals in the body might be causing the condition or predisposing the person to that condition. But what should be known by the Sickle Cell Person is that certain acts and actions predispose him of her more to the condition and these situations should be avoided with all serious efforts. And some of these acts and actions include depriving oneself of enough sleep, causing the body to readjust to the new sleep patterns and these in turn causes the extra energy expended in keeping attentive and alert to have its tool on the rather fragile hemoglobin. Consequently, as the oxygen levels in the blood hemoglobin become low as a result of sleep deprivation, the sickle cell blood could hardly flow freely through any other veins, particularly the corpus cavernosa. The Sickle Cell Person should also investigate closely the certain food or drinks that predispose him or her more to the condition. This requires careful attention to a variety of acts engaged in during the day, sitting postures assumed at workplace, the amount of water taken and the kind of food eaten. These permutations aids in understanding of the working mechanisms of the body and how one could detect what might have caused the condition. Excessive masturbation, high intake of caffeine products, dehydration, inappropriate sitting positions and many others could predispose a sickle cell person more to the condition.

And finally, to add and most importantly, one unexperimented yet effective, efficient and worthy therapy is a strong and effectual, fervent prayer. It works more than one could imagine. And the results of prayer are self-relieving as Soren Kierkegaard beautifully puts it,

“Prayer does not change God, but it changes him who prays”.

So pray, and the good Lord will lift that cup from you.
 

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