@@WhiteOak09 And hormones and testosterone in women. Most of the times it is hormones and optimization is life changing for women. Most feel very badly about no longer having a sex drive but there are solutions.
NEW SUBSCRIBER !!!!! LOVE TO HEAR WOMEN talking about sexual issues. Particularly , sexy , intelligent women talking openly (finally) , about a serious , pertinent issue.
At 77 I have been completely unaware of the solutions presented here. I just thought it was a result of aging that I could not have any control over. Now I will look further & harder to educate myself. I'd be happy to get back to where I was at 50 (or 45?) if possible. I just stumbled across this on TH-cam. Thank you all for what you do & present.
I am your age Dennis. I have a good sex life because of viagra. Many of my friends in my age group gave up on sex a long time ago. I tell them all to try it.
Taking the pill on an empty stomach makes a huge difference. I can take it 5 or more hours before "showtime" and it works well for me, on an empty stomach.
I started to think I had a ED problem , but after seeing you two for a few minutes .. I discovered it was all in my mind... thanks for the video Ladies ...
well this is more than theoretically true.... many men are 'blamed' for not being able to be aroused in their older age, but that arousal is inspired by who they are with. its a two-way street. not only his his testosterone levels lower with his increased age, but his partner will also be different through the same aging process. would be an interesting study to take 'low libido' men and give them what they might describe as their 'ideal sex partner' to see what percentage of these do not have biological problems, but are more inspiration based issues.
This is a FANTASTIC podcast! Thank you so much for taking the time to put this together. Every man (& woman with a man lol) needs to hear all this info asap 💯🙏🏽
Thanks for the good reporting. I recommend that at the end of every presentation you give a summary of exactly what a man should do in priority order. So from what I heard I think your summary should be: get your testosterone to the right level, then use nitrous oxide pills, then determine the right milligrams of Cialis and Viagra and frequency that you get the best results, then acoustic wave therapy, then if you still need help check into PT 141. How would you improve that list?
for sildenafil most have not been told to take it before eating hours earlier than you were expecting. Generally it says to take 1 to 1.5 hours before "need". This is news to me as well. Interesting topic
I take 5mg daily and on the nights I think I'm going to get lucky I take two around 5pm. What's nice about Cialis is it stays on you body for 3 days. I've done fasting at night and it helps too.
It is a great conversation with an educative value for a person like me who is sitting thousands of miles away. Keep up the good work. I ve subscribed your prog.
Coming from at bodybuilding point test is a must but arousal is a must & not all men are attracted to women getting older & young females aren't all attracted to older men so there's more then just hormones involved. Men are visual creatures.
I agree, though sleeping with a younger very attractive female initially does give an instant boost to an older mans sex drive/performance, after a few months the initial excitement is reduced and the same problems will in the majority of men start to reoccur.
I did HRT for a while. It's poorly reimbursed by most perscription plans. The insurance companies insist that you go with the Testosterone patches first. These patches have a major drawback - painful skin rash that last for several days after. So most men stop using the patches after a month or two. The insurance companies will not cover anything additional since most men do not use the patches long enough. The insurance companies win / you lose.
Put 40 drops of DMSO in your 200mg Vial of Testosterone using the 18 gauge drawing needle. Shake it up and put 3 drops in the crease of your elbow. It will absorb at 99.9% At this rate 1 drop is equal to 1mg more or less. I have only met one man who needed 4 drops per day. I feel like Million bucks now everyday. You are welcome:)
I have an older female friend who donates breastmilk and I help her keep her volume up and noticed that I get spontaneous elections and the joint pain from arthritis is much improved. I'm 64 and no other therapy or treatments talked about here are used.
@@conniealldisDMSO is cool stuff! (I’m a chemist so…) Only thing is most will not continue once they “taste” the DMSO. Some say it’s like garlic and others likened it to chewing aluminum foil. I wouldn’t know as it doesn’t affect me and why I was the one tasked with using it at the vet’s office I worked at years ago.
many more people are using cannabis products. This really has a negative impact on the ability to attain and maintain an erection, even with Sildenafil. This is why I no longer use cannabis and no longer have a problem with erections, and no longer use Sildenafil. I do take L-Citruline, but will Beetroot. My T-levels are still adequate. I'm 63, so I'll definitely be more informed and ask more questions when I go for my next physical. Thanks!
I have had prostate cancer so I don't think any doctor would recommend testosterone. I know I was low when I first found out that I had cancer 7 years ago.
I've never used either. I am fortunately problem free in this area. My total testosterone is 680 ng/dl and my free testosterone is 105. Great bp. Good triglycerides. High cholesterol is my only issue. _However_ . . . when I was about 40, I suddenly noticed a lowering libido and fewer orgasms. I have been over-sexed since childhood. So the difference wasn't too big of a deal, but it did give me pause. I had a few other health issues that were cropping up as well so I went on a carnivore diet for 6 months. My libido and drive returned enormously. I began slowly reintroducing foods after the six month mark. Long story short - I cut out all refined sugar all of the time and restrict fruit to berries in season. All carbs are from leafy greens. Basically a KETO diet with intermittent fasting. My drive has returned to the same levels I had in my 30s. Maybe sugar is the issue for a lot of these fellas? Worth investigating.
I noted a large increase in drive when I was on carnivore for 4 months pretty hardcore but I had to back off that lifestyle as I started to develop some negative health effects. And very quickly my drive decreased.
@@jdogswifty4372 Carnivore is an excellent elimination diet, or reset diet. But, for me, the healthy keto / IF diet has changed my life for the better and has served me well for over 3 years now.
@Zippitydoodah yep, I am getting ready to start a 60 day carnicado diet (yep I just made that one up). Plan is just 60 days carnivore with 1 avocado a day. Heavy fats 200+ grams a day. Once that 60 days are up I plan to slide back into a whole food keto plan going forward from there. Thank you for your insights they are much appreciated!
Been on 5 mg Cialis 2 times daily for BPH for 1.5 yrs. Results are amazing on improving long term memory and balance (which is amazing) at 78 yrs of age! Cialis helps my cardiovascular efficiency during exercise and 5 mg twice daily and is great because Cialis has 4 times the 1/2 life of Viagra!
Fantastic video. I would like you to make another explaining the different testosterone replacement therapies available including how the are administered and their common side effects.
@bwazi5455 testosterone is a major driver of prostate cancer. That's already one known side effect. Up to the users if they want to increase its level I suppose.
Fabulous podcast! It's probably been mentioned already, but still I'll add that as we move into our 50s and beyond, other health issues may come into play and the impact on libido is significant. There's no cure for some of these issues although workarounds may exist. At age 76 I sure wish I'd worked less and had sex more often! 😂
This was a great conversation & I learned a ton! Do you all have any colleagues or know of any urologists in the Bay Area (I live in Oakland) who provide the range of treatments you and Dr. Ibrahim talked about? Again, excellent convo!
Thank you for reaching out to us after watching our TH-cam video! We're glad to hear that the content resonated with you. While we don't have a specific provider to recommend in the Bay Area area, we'd be happy to help manage your sexual wellness needs ourselves. We're confident we can help you address your concerns! To find out more, contact our office at 865-293-5828.
I'm 70 and have used Cialis maybe 10-years or so. ... I find dividing a 20 mg by thirds or quarters cut back on the flushing side effects. ... If you're older try a 5mg on a Friday morning then you're good till Sunday. ... If you enjoy walking and are active try using less and be patient till you find what works for you.
Very good pod cast. Excellent information. You're right. I had to figure out on my own how the ed pills worked. None of my doctors or pharmacists told me that these meds work best on a empty stomach.
The boring truth is that for guys in their 40s and 50s, sex is rarely a surprise event. The formula that works like a charm for me.. Start the morning with L-citrulline and gym - especially legs, go for a run too. Eat healthy all day and include greens and avoid greasy and fried foods. Drink lots of water. About 2 hours before when you expect things to go down, 10mg Levitra with some dark chocolate and Beet root. If you must drink, do it in moderation and consider drinking clear Agave Tequila. Like an 18yo!!
What is the cost of this combo shot therapy all the stuff you're talking about, can you go to any urologist, I would love to come to you guys you make it seem so easy comforting
A patient with a diabetic mellitus which is under control at the moment but still having erectile dysfunction with increase blood pressure. What is your advice and proper solution to it?
You said that Cialis needs to be taken on an empty stomach. If Cialis is taken on an empty stomach, and a meal is eaten an hour or so later, does that negate the effect of the drug going forward?
Yes. When I spoke to my doctor about prostate meds, I was just told they could add something that should a little more. Picking up the meds, I read "generic for cialis" and wondered what the female pharmacists were thinking. (But they've seen it all before.) I told the doctor that I didn't ask for cialis or mention ED, and he said no, Cialis often helps when an enlarged prostate has been weaking urine flow. Who know? (And SOMEONE should have told me.)
I'm 63, has a stroke at 60, I lost some firmness, Dr. Prescribed, a 20mg Cialis. And I'm back, it works. Today I feel like I wanna do a burnout in my mustang gt. Whew. I liked and scribbed, like the pretty ladies asked. 💯.
I didn't watch the video, but I know "first hand" Tart Cherry gets it up, ready and lasts for hours. It's also a great inflammation reducer. No prescription and no side affects.
I take Cialis daily , well for fun but also for prostate hyperplasia and it works for that, the flomax was horrible it felt like I’d been chemically neutered
He talked about Testosterone being very helpful, but he didn't mention that taking T also creates more Estrogen in the body. Estrogen is counterproductive to erections as well. I wish you would have also spoken more about Cialis as a treatment for BPH. I've heard that it helps with that as well, and could be a bonus in addition to the help with erections. Still a great video. Thanks
Hi there! Thank you so much for watching out video! With our hormone replacement patients, we monitor lab work every three months to ensure that we keep all levels within optimal range. We can utilize Anastrozole to block estrogen levels that are elevated. Thank you!
@@drdebradurst Thanks for the response. I was also taking Anastozole for that purpose, until I found out it gives you osteoporosis. Patients need to know the truth up front before they decide to start TRT. Like the shrinking of the testis that will never come back without medications. And the fact that the body will stop producing T on it's own once you start TRT.
@@alexxxisbatman Very true, but if your body has an adequate amount of E and you take Test you will produce extra E in you body in addition to what you already have causing you to have more than what you need. Excess E also is no good for you.
@@coplock6689 if you have low T, you probably have low e2. That’s how it’s works, you need testosterone as a substrate for estrogen synthesis. The body doesn’t just create estrogen, it gets metabolized from testosterone along with DHT.
I can tell you from my experience that it only takes a few days for erections to work better at 5 mg daily. It is a Vasodilator so it also helps with cardiovascular issues, shrinks prostate size, and helps with high blood pressure. In the past, I had been on the regular Viagra and Cialis you take when you want to and are getting ready for an evening with the wife. A nice dinner and a couple drinks is how we have always gotten "in the mood" so we never quite worked out the timing as the regular lil blue pill requires you to not drink or eat prior to the pill. Hence, we would always end with a feeling of disappointment for both of us and shame for me, even though she was always nice and caring about it (married 30 yrs her in her late 50’s). The 5 mg per day as a 60 yr old man IS the way to go. I do get a little bit of a stuffy nose every now and then (a potential side effect) but def worth the trade-off
I have been on the daily Cialis for I think 5 years. I am 63 yr old man now. In the beginning I was like 16 again. I am talking random rock hard erections, not any thought of sex on my mind. This lasted for about 6months but after 5 years it certainly not like that anymore. All my urologist says is double up of you are planning on sex. NO!! I don't want sex I want constant spontaneous erections again.
Thank you for listening and sharing your experience. Men are asking and want to know. It is best to hear from other men using the product so thank you! The RMD team
@@Dave-x8j We are all good with that. We love and do a great job communicating / treating men but we cannot share experiences directly on this topic. Unfortunately men are not always sharing this information as they are hanging together, so forums such as this work well!
@@drdebradurst you’re right. Women have always been a good bit more socialized to share intimate issues, concerns, seek advice and be vulnerable with other women. Men have no such social permission, at least not yet. Things are likely changing for the under 40 crowd as they have a broader array of cultural scripts from which to choose. Older guys have only one limited script. Most men have no place to go with their worries, fears or problems and other men are not socialized to care and are not equipped to deal with it. Instead it makes them recognize their own I securities and things they loath about themselves. Things they hope no one ever knows about them. I see this as actually pure toxic masculinity. It goes against all tenants of traditional masculinity, strength, virility and independence-it is read as unmanly. Although there are some, most men are not known for their empathy and willingness to put up with another man’s vulnerability. It is interpreted as weakness topped off with humiliation. We have been taught to feel it’s cringy and uncool to share intimate fears and concerns. My final thought on this is, that women are rewarded for demonstrating vulnerability, and men find it attractive because it gives them something to do, they feel more needed, and can express their masculinity. Men, traditionally have never been rewarded for expressing vulnerability, only punished for it by both genders and the system.
Hi Dr. Durst. I was hard pressed to find anything wrong with your video. Keep up the good work! Any idea as to what size machine (power) required to help W/E.D. ?
I'm a 73 year old man. Looking at a recent lab report, my Testosterone reading is 706. The range is 221-871. Is this range like old man range or what? I don't perform like a young man anymore.
Thank you for your desire to share your knowledge with us. It is very encouraging to learn that there are options to prescription meds that have been ineffective. I am 70 years old with no underlying health issues and searching for a physician that will follow a similar protocol (like yourself and Dr Ibrahim suggest) of blood work and hormone improvements FIRST. Can you offer advice or links to facilities near my home in MS?
Thank you for your kind words, @user-xl3oz6rm3t. It's great to hear that you're interested in exploring alternative options to prescription medications. Finding a physician who prioritizes blood work and hormone improvements can be beneficial. While I don't have specific information on facilities in Mississippi, I recommend looking at the provider directory for your area on the American Academy of Anti-Aging (A4M) website. Additionally, discussing your needs with your primary care physician or seeking referrals from trusted individuals in your area can help. For personalized treatment, we encourage you to schedule a consultation with our clinic by calling 865.293.5828. Best of luck in finding a physician who aligns with your desired approach!
Wow!! Great input from you'll. What a great podcast. This is the first doctor/urologist that explains this clear and concise. I'm 65, and have been on hormone replacement & Viagra for 7 plus years. Yes, empty stomach is better. And if you have a fatty meal, forget it, lol. Mornings are better/perfect, or have your fun b4 dinner. Cialis sucks in my opinion. Viagra is much stronger. Also, get in shape, loose weight. Get in the gym 2 to 3 times a week. Also, if you're 30 to 40 pounds, or more, over weight, it's gonna be a struggle. 👍🎩👍
@B F2021 No I don’t I’m 55 and use it about once a week I cut a 5 in half 30 minutes before, it helps me keep going I go soft without it I had side effects with viagra flushing, nasal headache I prefer cialis
I heard the gentleman Dr. say something about a lozenges, what was that? And also, what PT 141. What kind of Dr. treats for this type of issue? How do I search or find a doctor that treats for this. I am not in your area, or I'd go to your location.
I am a retired orthopedic surgeon and would like to know if your familiar with BEMER therapy as a means to increase blood flow? The BEMER device uses a type of PEMF therapy and is currently a Class 2 medical device according to the FDA.
I'm 65, and use to be on citalopram. It causes erectile dysfunction. Even with Viagra. So, I stopped taking it. Also, by the way, I'm on hormone replacement therapy as well. Testosterone cypionate. About 100mg every 5 to 7 days. Injections I take at home. Elevating testosterone levels, may help with depression also.
Great information and I'll agree with the previous comments on how beautiful you both are ❤ Look forward to more information from two beautiful ladies. 😊
What are the side effects of taking testosterone? Hair loss? And if you have heart issues is there a problem with that including the meds you are taking for the heart?
Holy crap I had no idea my daily Zyrtec was a possible root cause for my ED. I take daily cialis and while it works ok, I am curious if halting my Zyrtec will provide better consistent results.
Hi, where can I go to get tested for testosterone levels? I’m here in palm desert, California. But I am concerned about cardiac and cancer. I’ve worked in cardiac for 25 yrs so I am concerned about heart issues. But I need education. Please point me in the right direction rather than just getting a pill. Thx
This is very informative and thank you for that. Question: What if your Testosterone levels are normal and you still have ED? What would be the next step?
Thank you for sharing your experience, @marcjames3487. Cialis can indeed work effectively as a one-off medication, providing results within an hour. It's important to find the right approach that works for you. There are so many options available for men to help improve sexual function! If you have any further questions or concerns, or if you'd like to explore other treatment options, we recommend reaching out to our clinic at 865.293.5828 for a consultation. Our team can discuss potential solutions tailored to your needs. Thank you for your comment!
It could be a variety of things (hormone levels are not in an optimal range, thyroid issues, vitamin deficiencies) -- give us a call at 865-293-5828 to set up a consult for more information!
I can't understand why he wouldn't recognize the positive effects daily cialis has on the cardiovascular system, which is one of the reason I take it, to increase NO2 levels. 5mg a day works wonders for me and I'm 53, my wife is 52. We are quite spontaneous which is another reason I like the daily 5mg dose. If I know we are going to be more active I'll take a second one later in the day, closer to the time we are going to be together. And always on an empty stomach, I thought that was common knowledge.
I noticed you are Knox area. I'm in Chatt. There are places like Chatt Mens Clinic. Is that a good place to go for consult and therapy? Or, should I plan on travel to the Knox or Atl area's for help? Thanks, Love you're education and knowledge.
I'm 71 and my T- level is 996. feeling good. no side effects. I looked into the P-shot. way to expensive. $1,200 to start for a 2-minute procedure. as a retired surgeon. that is stealing. I did ingrown toenails for $50. when everyone else charged $500. I made a fortune. I made more than them. I had no office. after surgery, I did house calls only. patterned after my mother's vet practice. my office was my 4 x 4 truck. treated many farmers on their tractor. because I did house calls, they came to me for primary care. especially the elderly. I greatly loved what I did. I miss it so much.
We understand your concerns regarding the cost of certain procedures @nathanielcohen9890. It's important to note that pricing for medical procedures can vary and is influenced by factors such as location, expertise, and the specific clinic or provider. Exploring different options and discussing costs with healthcare professionals can help you make an informed decision. Thank you for your engagement and all you have to help your patients over the years!!
@@drdebradurst thank you for your response. I understand. but by any other name it is stealing I understand and after careful consideration. I can do these 2 procedures for less than $100 and make a fortune. In fact you have inspired me to go back into practice. I can always use the extra cash.
Glad to hear it! Let us know when you do as we have patients all over the country looking for great providers. They may want an office environment and more than two minutes but sure you will do the right things.
So..My Dr. just prescribed me 20mg of Sildenafil (Generic) for Revatio.....I'm a little afraid to take it....Can you give me some insight as to how this compares to Viagra or Cialis... Really good podcast!!!! Thanks!
You haven't addressed another cause of erectile dysfunction. If a man is regularly viewing Pornography and masturbating to the images on the Screen, when he gets with a live woman, he can't perform. Its because the images flood his pre frontal cortex where no human in real life can match what he seen on the screen. Pornography is another cause for Erectile dysfunction. Look at Dr. Trish Lee's videos on TH-cam who does a better job explaining this problem.
Viagra is rivatio. Just a different strength. Develop for pulmonary hypertension and they found out another benefit. Kaiser gets a good deal on verbatio so they prescribe it instead of Viagra, they just prescribe more pills. I believe it comes 20 mg and they tell you to take five as a dose. If you don't have Kaiser a bottle of revatio will set you back more than a thousand dollars. America! Just like propecia and proscar are the same med. One is 1 mg for baldness the other is 5 mg for prostate. And they both cost the same. So I prescribe pro scar and tell my patients to quarter the pills and they save 75%.
Y’all say men are the problem but I went and did every test heart, nuclear stress, pulmonary etc and testosterone and was simply told I was “normal”. I’m there and open and listening. Hell even the nurse was shocked at how open I was. Pulmonary couldn’t figure out why I was there cause it was so good and asked so I was open and told them. The answer after all that is “here’s some pills , see ya, your old” I was told the occasional issue I was having was “normal” and “your test are normal”. Time and money to hear “normal” which doc here is saying I can’t point to it but I can. I can point all day in written stuff and verbal answers. I was told that if I wanted T I’d have to do test and kidney work and blahblahblah. I don’t want T but if I need T then freakin say so. I’ve figured it out on my own but it ain’t always “the men”. Y’all wanna lump well I’ll lump. I’m exhausted with DRs cause I’m normal. I’ll just figure it out
My wife needs help , I think she's turning into a nun .
😞 check out some of our videos regarding to o-shot or vaginal rejuvenation treatment. Hope that will help her.
@@drdebradurst thanks I will
@@WhiteOak09 And hormones and testosterone in women. Most of the times it is hormones and optimization is life changing for women. Most feel very badly about no longer having a sex drive but there are solutions.
I dated a NUN, SHE WAS not supposed to be out with me, CONVENT QUEEN, hot as a firecracker.
Hey Mr. Its better that way then if it was the other way 🤣🤣🤣 when the leg wraps up around you and no please not again😳🤕😳
Those two women are the best solutions against ED
i agree
If you like boring ones😂
Why doesn't anyone bring this up? If we're not wanted and desired, that's half the battle
Indeed,alternate one every other day
❤
NEW SUBSCRIBER !!!!! LOVE TO HEAR WOMEN talking about sexual issues. Particularly , sexy , intelligent women talking openly (finally) , about a serious , pertinent issue.
I’m very excited to hear people speak so professionally about this topic and with no nonsense and very knowledgeable
Thank you! We appreciate your support!
At 77 I have been completely unaware of the solutions presented here. I just thought it was a result of aging that I could not have any control over. Now I will look further & harder to educate myself. I'd be happy to get back to where I was at 50 (or 45?) if possible. I just stumbled across this on TH-cam. Thank you all for what you do & present.
We love that you found us! We love to educate our patients whenever possible! Do you have any specific topics you would like us to address?
I am your age Dennis. I have a good sex life because of viagra. Many of my friends in my age group gave up on sex a long time ago. I tell them all to try it.
Taking the pill on an empty stomach makes a huge difference. I can take it 5 or more hours before "showtime" and it works well for me, on an empty stomach.
Same here 💯
I started to think I had a ED problem , but after seeing you two for a few minutes .. I discovered it was all in my mind... thanks for the video Ladies ...
well this is more than theoretically true.... many men are 'blamed' for not being able to be aroused in their older age, but that arousal is inspired by who they are with. its a two-way street. not only his his testosterone levels lower with his increased age, but his partner will also be different through the same aging process. would be an interesting study to take 'low libido' men and give them what they might describe as their 'ideal sex partner' to see what percentage of these do not have biological problems, but are more inspiration based issues.
They are definitely a cure for ED.
In ur mind& somewhere else!👍
Good info!
Yep. It’s in my mind too, but it’s tough to narrow it down and try and overcome it. Suggestions?
This is a FANTASTIC podcast! Thank you so much for taking the time to put this together. Every man (& woman with a man lol) needs to hear all this info asap 💯🙏🏽
You are welcome!! Thank you for watching. Don't forget to like and subscribe to our channel for more similar content!
You are most welcomed, and thank you!
You do realize she's an emergency dr. and is a she. So what would she know about this subject
Thanks for the good reporting. I recommend that at the end of every presentation you give a summary of exactly what a man should do in priority order. So from what I heard I think your summary should be: get your testosterone to the right level, then use nitrous oxide pills, then determine the right milligrams of Cialis and Viagra and frequency that you get the best results, then acoustic wave therapy, then if you still need help check into PT 141.
How would you improve that list?
This is so refreshingly informative!
So much that a regular office visit doesn’t inform
Thank You!
for sildenafil most have not been told to take it before eating hours earlier than you were expecting. Generally it says to take 1 to 1.5 hours before "need". This is news to me as well. Interesting topic
I take 5mg daily and on the nights I think I'm going to get lucky I take two around 5pm.
What's nice about Cialis is it stays on you body for 3 days.
I've done fasting at night and it helps too.
Cialis works in 15 mins and is long lasting...if you are long lasting,..it will help power you through long sessions.😮
It is a great conversation with an educative value for a person like me who is sitting thousands of miles away. Keep up the good work. I ve subscribed your prog.
We have lots of patients who are remote - even thousands of miles away! Give us a call at 865-293-5828 if you want to set up a consultation!
Coming from at bodybuilding point test is a must but arousal is a must & not all men are attracted to women getting older & young females aren't all attracted to older men so there's more then just hormones involved. Men are visual creatures.
Its all about attraction
@@Ragnar-Viking Correct & I'm not attracted to older females.
Absolutely, I can get aroused for a middle-aged woman if she has kept herself up like I do. But if she's let herself go it's just not happening
I agree, though sleeping with a younger very attractive female initially does give an instant boost to an older mans sex drive/performance, after a few months the initial excitement is reduced and the same problems will in the majority of men start to reoccur.
@@judex3226 I do agree. Since I made this comment I had action & it does get old. You can't beat father time.
I did HRT for a while. It's poorly reimbursed by most perscription plans. The insurance companies insist that you go with the Testosterone patches first. These patches have a major drawback - painful skin rash that last for several days after. So most men stop using the patches after a month or two. The insurance companies will not cover anything additional since most men do not use the patches long enough. The insurance companies win / you lose.
Put 40 drops of DMSO in your 200mg Vial of Testosterone using the 18 gauge drawing needle. Shake it up and put 3 drops in the crease of your elbow. It will absorb at 99.9% At this rate 1 drop is equal to 1mg more or less. I have only met one man who needed 4 drops per day. I feel like Million bucks now everyday. You are welcome:)
I have an older female friend who donates breastmilk and I help her keep her volume up and noticed that I get spontaneous elections and the joint pain from arthritis is much improved. I'm 64 and no other therapy or treatments talked about here are used.
@Nicholas TV Yeah ok and?
Sub Q injections only.
@@conniealldisDMSO is cool stuff! (I’m a chemist so…) Only thing is most will not continue once they “taste” the DMSO. Some say it’s like garlic and others likened it to chewing aluminum foil. I wouldn’t know as it doesn’t affect me and why I was the one tasked with using it at the vet’s office I worked at years ago.
Any more info on PT-141? How to take where to buy, etc?
many more people are using cannabis products. This really has a negative impact on the ability to attain and maintain an erection, even with Sildenafil. This is why I no longer use cannabis and no longer have a problem with erections, and no longer use Sildenafil. I do take L-Citruline, but will Beetroot. My T-levels are still adequate. I'm 63, so I'll definitely be more informed and ask more questions when I go for my next physical.
Thanks!
I heard this about weed...glad I don't use
That might be a side effect of TCH use for some folks, but it has the opposite effect on me. A couple of tokes and I'm ready to go.
Hi Doc. I’m a first time watcher. Very impressed by the presentation. Any recommendations on a testosterone supplement? Thanks.
Supplements simply don't work. Go to a practitioner who specialises in Test and get onto it via injections! Best thing I ever did..
What is the best l citruline supplement?
I have had prostate cancer so I don't think any doctor would recommend testosterone. I know I was low when I first found out that I had cancer 7 years ago.
I've never used either. I am fortunately problem free in this area. My total testosterone is 680 ng/dl and my free testosterone is 105.
Great bp. Good triglycerides. High cholesterol is my only issue. _However_ . . . when I was about 40, I suddenly noticed a lowering libido and fewer orgasms. I have been over-sexed since childhood. So the difference wasn't too big of a deal, but it did give me pause. I had a few other health issues that were cropping up as well so I went on a carnivore diet for 6 months. My libido and drive returned enormously.
I began slowly reintroducing foods after the six month mark. Long story short - I cut out all refined sugar all of the time and restrict fruit to berries in season. All carbs are from leafy greens. Basically a KETO diet with intermittent fasting. My drive has returned to the same levels I had in my 30s. Maybe sugar is the issue for a lot of these fellas? Worth investigating.
How old are you, may I ask?
@@bigdre8917 56
I noted a large increase in drive when I was on carnivore for 4 months pretty hardcore but I had to back off that lifestyle as I started to develop some negative health effects. And very quickly my drive decreased.
@@jdogswifty4372 Carnivore is an excellent elimination diet, or reset diet. But, for me, the healthy keto / IF diet has changed my life for the better and has served me well for over 3 years now.
@Zippitydoodah yep, I am getting ready to start a 60 day carnicado diet (yep I just made that one up). Plan is just 60 days carnivore with 1 avocado a day. Heavy fats 200+ grams a day. Once that 60 days are up I plan to slide back into a whole food keto plan going forward from there. Thank you for your insights they are much appreciated!
This is the hottest doctor-nurse combo I've ever seen.
They know there stuff just listen
I thought they were sisters.
Simp.
Yep, 😊👍 They look like they could make an Movie!
Thank You for the kind words!!
Been on 5 mg Cialis 2 times daily for BPH for 1.5 yrs. Results are amazing on improving long term memory and balance (which is amazing) at 78 yrs of age! Cialis helps my cardiovascular efficiency during exercise and 5 mg twice daily and is great because Cialis has 4 times the 1/2 life of Viagra!
Y F n A it does bro!
@@kickicker6058 Lot of truth in just 14 letters (and an explanation point)!
I totally agree with you, I'm 63 and Latina wife is 46 and she loves it I can go at anytime 🔥🔥🔥
@@sammiejohnson2618 Oh to be young again!
How does it help memory?
Fantastic video. I would like you to make another explaining the different testosterone replacement therapies available including how the are administered and their common side effects.
I took the Cialis 5mg and it worked on the first day!
True...... a whole month for it to work is the biggest Hogwash I ever heard
@@nel1803 I agree.
@@nel1803 Its when you take 2.5 mg
Same here. It worked the first time
What about the side effects of giving testosterone hormone?
Depends on you everyone is different all I can say is test is best been on it for 14years I'm 60 now love it
@bwazi5455 testosterone is a major driver of prostate cancer. That's already one known side effect. Up to the users if they want to increase its level I suppose.
Fabulous podcast! It's probably been mentioned already, but still I'll add that as we move into our 50s and beyond, other health issues may come into play and the impact on libido is significant. There's no cure for some of these issues although workarounds may exist. At age 76 I sure wish I'd worked less and had sex more often! 😂
This was a great conversation & I learned a ton! Do you all have any colleagues or know of any urologists in the Bay Area (I live in Oakland) who provide the range of treatments you and Dr. Ibrahim talked about? Again, excellent convo!
Thank you for reaching out to us after watching our TH-cam video! We're glad to hear that the content resonated with you. While we don't have a specific provider to recommend in the Bay Area area, we'd be happy to help manage your sexual wellness needs ourselves. We're confident we can help you address your concerns! To find out more, contact our office at 865-293-5828.
Where is your office located at?…state?….city?…etc.
where is your office located at?….state?…city?…etc.
I'm 74 and cialis is brill. I take a 20 mg tablet, and find the effects can last 3 days.
I'm 70 and have used Cialis maybe 10-years or so. ... I find dividing a 20 mg by thirds or quarters cut back on the flushing side effects. ... If you're older try a 5mg on a Friday morning then you're good till Sunday. ... If you enjoy walking and are active try using less and be patient till you find what works for you.
68 years of Age..I approve this Message...😂😂😂😂❤❤❤❤
That is not true for everyone .
I had 26 rounds of radiation for prostate cancer. My psa was never over 5. The treatment was worse than the cancer.
Unless the cancer killed you, of course.
Good information, I tried one of the pills was very disappointed. Then when I read about the long-term side effects I stopped all together
The best video I’ve watched on this issue!
Thank You for watching!
Very good pod cast. Excellent information. You're right. I had to figure out on my own how the ed pills worked. None of my doctors or pharmacists told me that these meds work best on a empty stomach.
We are glad our content was helpful and appreciate the positive feedback! Thank you for commenting
The boring truth is that for guys in their 40s and 50s, sex is rarely a surprise event. The formula that works like a charm for me.. Start the morning with L-citrulline and gym - especially legs, go for a run too. Eat healthy all day and include greens and avoid greasy and fried foods. Drink lots of water. About 2 hours before when you expect things to go down, 10mg Levitra with some dark chocolate and Beet root. If you must drink, do it in moderation and consider drinking clear Agave Tequila. Like an 18yo!!
great protocol!
Pill is easier
What is the cost of this combo shot therapy all the stuff you're talking about, can you go to any urologist, I would love to come to you guys you make it seem so easy comforting
Wish we had some great clinics like this closer!
The 3 of these people know what they are talking about.🎉😎
A patient with a diabetic mellitus which is under control at the moment but still having erectile dysfunction with increase blood pressure. What is your advice and proper solution to it?
You said that Cialis needs to be taken on an empty stomach. If Cialis is taken on an empty stomach, and a meal is eaten an hour or so later, does that negate the effect of the drug going forward?
His background is Extensive ! Hahaha i laughed couldn't help it .😂
You mention testosterone supplements and P shots in your show for ED in old age. Where do I find this treatment in New Zealand? Thank you..
I learned a lot from listening to professionals. Thank you!
Glad it was helpful!
👍very great information! very needed! Many doctors she would be completely uneducated call regarding this! Thanks
Excellent discussion! I agree, most doctor don't really explain how to use the pills correctly.
Thank you!
Im 60 and watching these two BEAUTIFUL Women are doing it for me. Giggity!
Thanks for Watching! Tune in for more!
Dr, Durst is all you need.
Great advice. Thank you. Clearly I need hormone therapy. How do I get this. Find a urologist?
yes i m TRT since 25years without any issue
The 5mg is also used for the prostate! That is Cialis.
Yes. When I spoke to my doctor about prostate meds, I was just told they could add something that should a little more. Picking up the meds, I read "generic for cialis" and wondered what the female pharmacists were thinking. (But they've seen it all before.) I told the doctor that I didn't ask for cialis or mention ED, and he said no, Cialis often helps when an enlarged prostate has been weaking urine flow.
Who know? (And SOMEONE should have told me.)
I'm 63, has a stroke at 60, I lost some firmness, Dr. Prescribed, a 20mg Cialis. And I'm back, it works. Today I feel like I wanna do a burnout in my mustang gt. Whew. I liked and scribbed, like the pretty ladies asked. 💯.
Thank you so much for sharing your story and your support! I'm glad you found a solution that works for you. Keep enjoying the ride!
@@drdebradurst thanks again and happy New Year. 😍.
I didn't watch the video, but I know "first hand" Tart Cherry gets it up, ready and lasts for hours. It's also a great inflammation reducer. No prescription and no side affects.
What brand do you use?
No clue what that is…
@@bowe4710❤❤
Great job you guys are really educaters.looking forward to seeing you guys again
I take Cialis daily , well for fun but also for prostate hyperplasia and it works for that, the flomax was horrible it felt like I’d been chemically neutered
Me too, it was a bonus side effect. I think I’m going to try the 3mg.
Enjoyed the topic. Would appreciate it when you are disgusting a particular item or treatment buy putting it up on the screen.
What about the link between prostate cancer and testosterone?
i have been on TRT since 25years without any issue and loving it.i take 0.05ml every week in doctor office
Could Testosterone Treatments cause prostate cancer?
He talked about Testosterone being very helpful, but he didn't mention that taking T also creates more Estrogen in the body. Estrogen is counterproductive to erections as well. I wish you would have also spoken more about Cialis as a treatment for BPH. I've heard that it helps with that as well, and could be a bonus in addition to the help with erections. Still a great video. Thanks
Hi there! Thank you so much for watching out video!
With our hormone replacement patients, we monitor lab work every three months to ensure that we keep all levels within optimal range. We can utilize Anastrozole to block estrogen levels that are elevated. Thank you!
@@drdebradurst Thanks for the response. I was also taking Anastozole for that purpose, until I found out it gives you osteoporosis. Patients need to know the truth up front before they decide to start TRT. Like the shrinking of the testis that will never come back without medications. And the fact that the body will stop producing T on it's own once you start TRT.
Having adequate estrogen is just as important as testosterone for sexual functioning. Low estrogen = no libido
@@alexxxisbatman Very true, but if your body has an adequate amount of E and you take Test you will produce extra E in you body in addition to what you already have causing you to have more than what you need. Excess E also is no good for you.
@@coplock6689 if you have low T, you probably have low e2. That’s how it’s works, you need testosterone as a substrate for estrogen synthesis. The body doesn’t just create estrogen, it gets metabolized from testosterone along with DHT.
Aren't most urologists against testosterone replacement therapy, thinking that it might increase the likelihood of getting prostate cancer?
Why doesn’t she move the mic so that she can face the guest and talk into it as well?
This is the first I had heard of the full stomach issue. It makes sense, but no dr had ever said anything.
thanks for watching and yes a few doctors don't mention it.
I can tell you from my experience that it only takes a few days for erections to work better at 5 mg daily. It is a Vasodilator so it also helps with cardiovascular issues, shrinks prostate size, and helps with high blood pressure. In the past, I had been on the regular Viagra and Cialis you take when you want to and are getting ready for an evening with the wife.
A nice dinner and a couple drinks is how we have always gotten "in the mood" so we never quite worked out the timing as the regular lil blue pill requires you to not drink or eat prior to the pill. Hence, we would always end with a feeling of disappointment for both of us and shame for me, even though she was always nice and caring about it (married 30 yrs her in her late 50’s). The 5 mg per day as a 60 yr old man IS the way to go. I do get a little bit of a stuffy nose every now and then (a potential side effect) but def worth the trade-off
I have been on the daily Cialis for I think 5 years. I am 63 yr old man now. In the beginning I was like 16 again. I am talking random rock hard erections, not any thought of sex on my mind. This lasted for about 6months but after 5 years it certainly not like that anymore. All my urologist says is double up of you are planning on sex. NO!! I don't want sex I want constant spontaneous erections again.
@@seanmann863- PumpkinSeeds are your friend!
Thank you for listening and sharing your experience. Men are asking and want to know. It is best to hear from other men using the product so thank you! The RMD team
@@Dave-x8j We are all good with that. We love and do a great job communicating / treating men but we cannot share experiences directly on this topic. Unfortunately men are not always sharing this information as they are hanging together, so forums such as this work well!
@@drdebradurst you’re right. Women have always been a good bit more socialized to share intimate issues, concerns, seek advice and be vulnerable with other women.
Men have no such social permission, at least not yet. Things are likely changing for the under 40 crowd as they have a broader array of cultural scripts from which to choose. Older guys have only one limited script. Most men have no place to go with their worries, fears or problems and other men are not socialized to care and are not equipped to deal with it. Instead it makes them recognize their own I securities and things they loath about themselves. Things they hope no one ever knows about them. I see this as actually pure toxic masculinity. It goes against all tenants of traditional masculinity, strength, virility and independence-it is read as unmanly. Although there are some, most men are not known for their empathy and willingness to put up with another man’s vulnerability. It is interpreted as weakness topped off with humiliation. We have been taught to feel it’s cringy and uncool to share intimate fears and concerns.
My final thought on this is, that women are rewarded for demonstrating vulnerability, and men find it attractive because it gives them something to do, they feel more needed, and can express their masculinity. Men, traditionally have never been rewarded for expressing vulnerability, only punished for it by both genders and the system.
Hi Dr. Durst. I was hard pressed to find anything wrong with your video. Keep up the good work! Any idea as to what size machine (power) required to help W/E.D. ?
I'm a 73 year old man. Looking at a recent lab report, my Testosterone reading is 706. The range is 221-871. Is this range like old man range or what? I don't perform like a young man anymore.
u have the best T level but i m sure u lost the libido so cialis will bring back ur libido
Thank you for your desire to share your knowledge with us. It is very encouraging to learn that there are options to prescription meds that have been ineffective.
I am 70 years old with no underlying health issues and searching for a physician that will follow a similar protocol (like yourself and Dr Ibrahim suggest) of blood work and hormone improvements FIRST.
Can you offer advice or links to facilities near my home in MS?
Thank you for your kind words, @user-xl3oz6rm3t. It's great to hear that you're interested in exploring alternative options to prescription medications. Finding a physician who prioritizes blood work and hormone improvements can be beneficial. While I don't have specific information on facilities in Mississippi, I recommend looking at the provider directory for your area on the American Academy of Anti-Aging (A4M) website. Additionally, discussing your needs with your primary care physician or seeking referrals from trusted individuals in your area can help. For personalized treatment, we encourage you to schedule a consultation with our clinic by calling 865.293.5828. Best of luck in finding a physician who aligns with your desired approach!
Wow!!
Great input from you'll.
What a great podcast. This is the first doctor/urologist that explains this clear and concise.
I'm 65, and have been on hormone replacement & Viagra for 7 plus years. Yes, empty stomach is better. And if you have a fatty meal, forget it, lol. Mornings are better/perfect, or have your fun b4 dinner. Cialis sucks in my opinion. Viagra is much stronger. Also, get in shape, loose weight. Get in the gym 2 to 3 times a week. Also, if you're 30 to 40 pounds, or more, over weight, it's gonna be a struggle.
👍🎩👍
Cialis works better to me it makes you last longer and swell larger, viagra just gets you off quicker
@B F2021 No I don’t I’m 55 and use it about once a week I cut a 5 in half 30 minutes before, it helps me keep going I go soft without it I had side effects with viagra flushing, nasal headache I prefer cialis
@B F2021 I have never had any side affects to me it’s better I get thicker and don’t get off as easy I can control it better, good luck
*LOSE weight
@@tribzman3977
YES!!
Get body fat down to 15% or lower. Will help also...
Way to bring it Dr Jorge!
It seems you're recommending testosterone supplement first, then nitric oxide, then maybe Viagra or Cialis?
I have learned more in the past 15min than I have over the years, the fact that, both that the 3 of present the facts
I heard the gentleman Dr. say something about a lozenges, what was that? And also, what PT 141. What kind of Dr. treats for this type of issue? How do I search or find a doctor that treats for this. I am not in your area, or I'd go to your location.
Hi DOCTOR DURST
WHERE DO I GET PEPTIDE 141 ?
I LIVE IN FRANCE
Keep the good videos coming
Thanx
CLAUDE
Thank you for watching Claude. Since you live in a different country. You might have to look online if PT-141 is offered there.
Doctor Durst is FINE FINE FINE LAWD, you dudes was thinking it i just said it for you , you all are WELCOME
Erectile dysfunction is not caused from lack of testosterone, it is caused from hardening of the arteries
20% of it is hormone issue which plays part of it and 80% is blood flow issue.
@@drdebradurstso how to correct the blood flow issues
I am a retired orthopedic surgeon and would like to know if your familiar with BEMER therapy as a means to increase blood flow? The BEMER device uses a type of PEMF therapy and is currently a Class 2 medical device according to the FDA.
Empty stomach is key….I use a little afrin nasal spray for the stuffy nose?
What about implants?
I'm curious about anti-depressants, like citalopram, and their effects on ED. Can these effects be overcome with Viagra or Cialis?
I'm 65, and use to be on citalopram.
It causes erectile dysfunction.
Even with Viagra. So, I stopped taking it. Also, by the way, I'm on hormone replacement therapy as well.
Testosterone cypionate. About 100mg every 5 to 7 days.
Injections I take at home.
Elevating testosterone levels, may help with depression also.
I take a low dose of citalopram and viagra still works at 70.
My concern with testosterone supplementation was always the risk of prostate cancer - has that been found to be less of an issue now days?
this is horseshit
Great podcast. Subscribed and will follow.
Welcome aboard! Thank you for watching!
Where can you purchase this nitric oxid?
Great information and I'll agree with the previous comments on how beautiful you both are ❤
Look forward to more information from two beautiful ladies. 😊
We appreciate you following along and watching our videos!
What are the side effects of taking testosterone? Hair loss? And if you have heart issues is there a problem with that including the meds you are taking for the heart?
So you can take Nitric Oxide the same day as Cialis? I currently take N.O as daily supplement
Great program, lots of info, great Dr's, Where do they practice?
Thanks You! Our office is located in TN!
Holy crap I had no idea my daily Zyrtec was a possible root cause for my ED. I take daily cialis and while it works ok, I am curious if halting my Zyrtec will provide better consistent results.
What medications you recommend to boost testosterone level
Hi, where can I go to get tested for testosterone levels? I’m here in palm desert, California. But I am concerned about cardiac and cancer. I’ve worked in cardiac for 25 yrs so I am concerned about heart issues. But I need education. Please point me in the right direction rather than just getting a pill. Thx
Dod yelp and Seach for trt. Plenty of placed that do it in your area.
Endocrinologist
Is there an increased risk of cancer while taking Testosterone?
This is very informative and thank you for that. Question: What if your Testosterone levels are normal and you still have ED? What would be the next step?
There are many solutions. Gainswave / Pshot / Botox are some options but start with consulting a sexual wellness physician.
@@drdebradurst PSHOT are useless.i spent 2000$ for 2days erection
I take 2.5 mg add hoc when I want it and it works great within an hour. I certainly don’t have to take it for a month for it to work!
Sounds like you have better than average results!
Just discovered your channel, and the guest is from my hometown, Asheville, NC. Very informative video. Will try nitric oxide, too.
Thank you for following along!
Fantastic information. Now I can go to my urologist with a whole lot of questions
Extremely constructive discussion
I'm wondering if there's been any studies done on cancer patients and the effects of the medication and ED..
Not my experience, Cialis works pretty well as a one off, needs maybe an hour to work. Also, it just keeps that body part interested for a few days.
Thank you for sharing your experience, @marcjames3487. Cialis can indeed work effectively as a one-off medication, providing results within an hour. It's important to find the right approach that works for you. There are so many options available for men to help improve sexual function! If you have any further questions or concerns, or if you'd like to explore other treatment options, we recommend reaching out to our clinic at 865.293.5828 for a consultation. Our team can discuss potential solutions tailored to your needs. Thank you for your comment!
thank your for this splendid interwiev. What about if you are on trt and still tired all the time. 52years old.
It could be a variety of things (hormone levels are not in an optimal range, thyroid issues, vitamin deficiencies) -- give us a call at 865-293-5828 to set up a consult for more information!
I can't understand why he wouldn't recognize the positive effects daily cialis has on the cardiovascular system, which is one of the reason I take it, to increase NO2 levels. 5mg a day works wonders for me and I'm 53, my wife is 52. We are quite spontaneous which is another reason I like the daily 5mg dose. If I know we are going to be more active I'll take a second one later in the day, closer to the time we are going to be together. And always on an empty stomach, I thought that was common knowledge.
I noticed you are Knox area. I'm in Chatt. There are places like Chatt Mens Clinic. Is that a good place to go for consult and therapy? Or, should I plan on travel to the Knox or Atl area's for help? Thanks, Love you're education and knowledge.
Fabulous and informative. Thank you. Learned a lot today
I'm 71 and my T- level is 996. feeling good. no side effects. I looked into the P-shot. way to expensive. $1,200 to start for a 2-minute procedure. as a retired surgeon. that is stealing. I did ingrown toenails for $50. when everyone else charged $500. I made a fortune. I made more than them. I had no office. after surgery, I did house calls only. patterned after my mother's vet practice. my office was my 4 x 4 truck. treated many farmers on their tractor. because I did house calls, they came to me for primary care. especially the elderly. I greatly loved what I did. I miss it so much.
We understand your concerns regarding the cost of certain procedures @nathanielcohen9890. It's important to note that pricing for medical procedures can vary and is influenced by factors such as location, expertise, and the specific clinic or provider. Exploring different options and discussing costs with healthcare professionals can help you make an informed decision. Thank you for your engagement and all you have to help your patients over the years!!
@@drdebradurst thank you for your response. I understand. but by any other name it is stealing I understand and after careful consideration. I can do these 2 procedures for less than $100 and make a fortune. In fact you have inspired me to go back into practice. I can always use the extra cash.
Glad to hear it! Let us know when you do as we have patients all over the country looking for great providers. They may want an office environment and more than two minutes but sure you will do the right things.
So..My Dr. just prescribed me 20mg of Sildenafil (Generic) for Revatio.....I'm a little afraid to
take it....Can you give me some insight as to how this compares to Viagra or Cialis...
Really good podcast!!!! Thanks!
You haven't addressed another cause of erectile dysfunction. If a man is regularly viewing Pornography and masturbating to the images on the Screen, when he gets with a live woman, he can't perform. Its because the images flood his pre frontal cortex where no human in real life can match what he seen on the screen. Pornography is another cause for Erectile dysfunction. Look at Dr. Trish Lee's videos on TH-cam who does a better job explaining this problem.
Viagra is rivatio. Just a different strength. Develop for pulmonary hypertension and they found out another benefit. Kaiser gets a good deal on verbatio so they prescribe it instead of Viagra, they just prescribe more pills. I believe it comes 20 mg and they tell you to take five as a dose. If you don't have Kaiser a bottle of revatio will set you back more than a thousand dollars. America!
Just like propecia and proscar are the same med. One is 1 mg for baldness the other is 5 mg for prostate. And they both cost the same. So I prescribe pro scar and tell my patients to quarter the pills and they save 75%.
cut it in quarter
Y’all say men are the problem but I went and did every test heart, nuclear stress, pulmonary etc and testosterone and was simply told I was “normal”. I’m there and open and listening. Hell even the nurse was shocked at how open I was. Pulmonary couldn’t figure out why I was there cause it was so good and asked so I was open and told them. The answer after all that is “here’s some pills , see ya, your old” I was told the occasional issue I was having was “normal” and “your test are normal”.
Time and money to hear “normal” which doc here is saying I can’t point to it but I can. I can point all day in written stuff and verbal answers.
I was told that if I wanted T I’d have to do test and kidney work and blahblahblah. I don’t want T but if I need T then freakin say so.
I’ve figured it out on my own but it ain’t always “the men”. Y’all wanna lump well I’ll lump. I’m exhausted with DRs cause I’m normal. I’ll just figure it out
you got to go to knoxville
Wish you guys were in Houston