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If you’ve ever witnessed someone suffer a stroke, you understand the humbling nature of this disease. It can reduce the mightiest human being to an immobile, helpless creature. Impairment of crucial functions like speech, walking, and control of bowel and bladder can wrench control from the body in a moment. Even perpetually youthful TV personality Dick Clark was struck down by stroke at age 75, despite the outward appearance of perfect health. Clark’s stroke resulted in a six-week hospital stay and, judging from fragmented reports, significant disability. Stroke can be like a devastating fire that strikes without warning, leaving only smoldering rubble. Stroke can so ravage basic bodily functions that often all you can hope for is to regain a portion through rehabilitation. The disease process that underlies stroke requires decades—30 or 40 years—to develop. With that much lead time, why aren’t we better able to detect or stop this crippling disease? The truth is that we are able to predict many, if not most, strokes. Advances in imaging technology allow detection of atherosclerotic plaque that cause stroke years before it becomes a threat. Progress in deciphering the causes of stroke has also leapt forward. Unfortunately, your neighborhood physician still focuses on diagnosing the crisis rather than anticipating it. Physicians prefer to deal with catastrophes and are just not that interested in prevention. Most physicians ask: “Is it time to operate or not?” The medical community obsesses over procedures like carotid endarterectomy (surgical removal of plaque) or carotid stents. Even when a person is afforded the warnings of a “mini-stroke”, or transient ischemic attack (TIA), little more is done once it’s determined that surgery is not necessary—even though this person has high risk for future stroke (50% over 10 years). Let’s flip-flop this approach to stroke. Procedures represent a failure of prevention! Where do strokes come from? Stroke develops when some portion of the brain is deprived of blood. This usually results from a tiny bit of debris that dislodges from an atherosclerotic plaque along the walls of an artery (the same sort that accumulates in coronaries causing heart attack). The sources of debris have been a subject of controversy, but new imaging technologies have settled the question. Any blood vessel that leads from the heart to the brain can be a source. The two carotid arteries on both sides of your neck are a frequent source, as these arteries are prone to develop plaque. (Our discussion will be confined to what are called thromboembolic, or ischemic, strokes, i.e, strokes that occur from plaque that fragments, sending debris to the brain, and will not include the far less common hemorrhagic strokes due to rupture of small vessels in the brain, nor will we discuss atrial fibrillation and other heart causes of stroke. The thromboembolic strokes we discuss cause around 88% of all strokes.) Over the last 10 years, the aorta has been recognized as another important source of stroke. The aorta is the main artery of the body whose branches go to the head, arms, and legs. Atherosclerotic plaque is a live tissue that, through poor diet, inactivity, high cholesterol, overweight, etc., grows and becomes progressively more unstable. At some point, plaque fragments. Little bits break away, traveling to the brain. Fractured plaque also exposes its deeper structures to flowing blood, triggering blood clot formation, which in turn can also fragment and go to the brain. Atherosclerotic plaque is a prerequisite for the most common causes of stroke. If the majority of strokes originate from plaque, why not measure plaque to determine if you’re at risk for stroke? How can we easily, safely, and accurately measure plaque in the carotid arteries and aorta? And if plaque can be measured, can it be shrunk or inactivated to reduce or eliminate risk for stroke? How can plaque be measured? Just 20 years ago, the only practical method of identifying plaque in the carotids or aorta was through angiography, requiring catheters inserted into the body to inject x-ray dye. Angiography was impractical as a screening measure. CT scanning and magnetic resonance imaging (MRI) are emerging as exciting methods of imaging both carotids and aorta. Unfortunately, most centers and physicians are much more focused on the diagnostic uses of these technologies for people who have already suffered stroke or other catastrophe, and application of these devices for preventive uses is still evolving. One exception is when aortic calcification or aortic enlargement is incidentally noted on the increasingly popular CT heart scans; this is an important finding that can signal presence of aortic plaque. The one test that is widely available and can be performed in just about any center is carotid ultrasound. It’s simple, painless, and precise. Two basic observations can be made: 1. Plaque detection—Atherosclerotic plaque can be clearly visualized. If plaque blocks more than 70% of the diameter of the vessel, or if there are “soft” (unstable) elements in plaque, then stroke risk may be high enough to justify surgery or stents. However, if there are plaques that are less severe, substantial risk for stroke may still be present that can be reduced with preventive measures. 2. Carotid intimal-medial thickness—This is a measure of the thickness of the lining of the carotid artery in areas not involved by plaque, but often precedes the development of mature plaque. Carotid intimal-medial thickness also provides an index of body-wide potential for atherosclerotic plaque that can place you at risk for stroke. The aorta, for instance, cannot be well imaged by surface ultrasound but can still be a source for stroke. Increased carotid intimal-medial thickness and carotid plaque are closely associated with likelihood of aortic plaque. The Rotterdam Study of 4000 participants demonstrated that if carotid intimal-medial thickness is greater than normal (1.0 mm), then you can be at risk for stroke (and heart attack), even if no carotid plaques are detected. Carotid ultrasound is the one test you should consider that provides the most information with least effort. Ultrasound is harmless, painless, and can be obtained just about anywhere. Even if your doctor disagrees with your request for a carotid ultrasound, an increasing number of mobile services are popping up nationwide that make this test available for around $100. One important point: many scanners and interpreters will only report whether plaque is present or not. While this is important information, you should request that the carotid-intimal medial thickness be made as well. Not all centers can make this simple measure (because of software requirements), but it doesn’t hurt to try. Any amount of carotid plaque is reason to follow a preventive program, even if the plaque is insufficient to justify surgery. Can plaque be reduced? Can we shrink plaque in carotid arteries and aorta and thereby reduce, perhaps eliminate, these sources of stroke? That question is gaining momentum as effective therapies become available that pack real punch for reducing plaque. Study after study has now documented that plaque can be reduced and, with it, risk for stroke. Reduction in plaque of 10–20% is possible within a year or two. Let’s consider the most potent influences on carotid and aortic plaque growth that need to be considered in a plaque-reducing program. (I assume that you are a non-smoker—if you are a smoker, you first need to concentrate on quitting.) Hypertension Considerable experience documents the power of blood pressure-lowering for prevention of stroke. The most recently updated guidelines, the JNC–VII, recommends a blood pressure of 407 mg/dl heightens stroke risk six-fold. C-reactive protein (CRP) This measure of inflammation is proving to be a useful marker for identifying people at risk for stroke, with increased risk beginning at a level of 0.5 mg/l. High CRP also predicts more rapidly growing carotid plaque. Homocysteine Homocysteine is an important marker of increased likelihood of both carotid and aortic plaque, as well as stroke. In 1997, the European Concerted Action Project reported more than a doubling of stroke when homocysteine levels exceeded 12 mol/l. As homocysteine increases to 20 μmol/l, risk for stroke and heart attack increases an amazing 10-fold over that at a level of 9 μmol/l. Asymmetric dimethylarginine (ADMA) ADMA is recently discovered amino acid whose blood levels can skyrocket up to 10-fold in the presence of hypertension, metabolic syndrome, diabetes, high cholesterol and triglycerides, obesity, and high homocysteine levels. ADMA blocks the action of the amino acid, l-arginine. This mimicry reduces the availability of nitric oxide, a powerful dilator and protector of arteries. ADMA levels in the top 10% predict a six-fold heightened risk for future stroke, and ADMA levels in people with strokes are double that in other people. A carotid ultrasound study in 116 subjects showed that higher blood levels of ADMA are associated with more severe carotid plaque. Because of ADMA’s shared role across a variety of abnormal conditions, correction or blocking the action of ADMA has been suggested as a unique therapeutic tool to reduce stroke risk. Cholesterol Data suggest that lowering cholesterol with statin cholesterol-lowering drugs slows carotid plaque growth and reduce stroke risk approximately 22%. An interesting study from the Cardiovascular Institute at Mt. Sinai School of Medicine in New York using the precise measuring ability of MRI of the carotids and thoracic aorta showed an impressive 20% regression of plaque area with simvastatin (Zocor®) taken for two years. Although guidelines for cholesterol treatment recommend reduction of LDL cholesterol to 100 mg/dl in high-risk persons, a report from the Walter Reed Army Medical Center in Washington, DC, showed that carotid plaque was more effectively reduced when LDL cholesterol of 70 mg/dl or lower was achieved with statin cholesterol drugs. Lower LDL cholesterol may, therefore, be better. Treatment Strategies to Reduce Carotid and Aortic Plaque The essential question: How do we reduce carotid and aortic plaque? If we make this the focus of our efforts, many pieces begin to fall into place. If you’ve had any measure of carotid or aortic plaque such as a carotid ultrasound or aortic calcification on a CT heart scan, you know that you’re at increased risk for stroke. You also have a baseline for future comparison to gauge whether your program is working or not. Because most people have not one but several causes of carotid and aortic plaque, there is no one single treatment that effectively eliminates risk for stroke. Instead, most people require a comprehensive program of healthy diet, exercise, supplements, and medication when indicated. Here, we focus on the nutritional supplements that can be critical components of your plaque-reduction program. Fish oil Fish oil is a cornerstone of your stroke prevention program. Epidemiological observations suggest a strong relationship of fish intake and reduction of stroke risk. Carotid ultrasound studies demonstrate less carotid plaque with greater intakes of fish. A cleverly designed University of Southampton study made the fascinating observation that fish oil transforms the structure of carotid plaque. 150 people with severe carotid plaque scheduled for carotid endarterectomy (surgical removal of the plaque) were given fish oil, sunflower oil, or no treatment over several months while waiting for their procedure. (Delays in the British health system permitted this unique design.) Plaque was removed at surgery and examined. Participants taking fish oil had reduced inflammation in plaque and thicker tissue covering the fatty core, markers of more stable plaque. Those taking sunflower oil or no treatment had unstable plaques with greater inflammation and thinner, less sturdy covering tissue. This suggests that fish oil stabilizes carotid plaque, making it less likely to rupture and fragment. A standard capsule of fish oil (containing 300 mg of EPA + DHA) contains the same amount of omega-3s as a 3 oz serving of cod or halibut; three capsules (900 mg DHA + EPA) contain the equivalent of a serving of farm-raised salmon. The dose that seems to provide greatest protection from stroke, lowers triglycerides (that form abnormal lipoproteins; see above), and reduces fibrinogen, is four capsules per day (1200 mg EPA + DHA). Coenzyme Q10 (CoQ10) Although there are no data specifically addressing whether CoQ10 reduces plaque, it is a marvelously effective way to reduce blood pressure, one of the crucial factors causing carotid and aortic plaque growth. A pooled analysis of eight studies showed that, on average, CoQ10 in daily doses of 50–200 mg reduced systolic blood pressure by 16 mm Hg, diastolic pressure by 10 mm Hg. Data suggest that CoQ10 can reverse abnormal heart muscle thickening (hypertrophy), another manifestation of high blood pressure, strongly suggesting that CoQ10 has benefits beyond just reducing pressure. Supplements to correct the metabolic syndrome Weight loss is, without question, the most immediate and direct path to correction of this dangerous pre-diabetic condition. A drop of even 10–20 lbs yields improvements across the board: increased sensitivity to insulin, increased HDL, and reductions in triglycerides, CRP, fibrinogen, small LDL particles, and blood pressure. Diet and exercise are fundamental components of an effort to lose weight; low carbohydrate or reduced glycemic index diets (e.g., South Beach or Mediterranean) rich in fibers are clearly effective. Several supplements can amplify weight-reduction efforts and be useful adjuncts to your lifestyle program. Among them: White bean extract White bean extract blocks intestinal absorption of carbohydrates by 66%. 1500 mg twice a day with meals yields, on average, 3–7 lbs of weight loss in the first month of use. The only side-effect is excessive gas, due to unabsorbed starches. Glucomannan This unique fiber taken prior to meals absorbs many times its weight in water and thereby fills your stomach. You consequently take in less food. Most people lose around four lbs per month using 1500 mg prior to each meal. Interestingly, glucomannan also blunts the rise in blood sugar after meals, an effect that, by itself, may lead to weight loss. Be sure to take with plenty of water. DHEA This adrenal hormone is key to maintaining physical stamina, mood, muscle mass in men, and libido in women. A recent randomized, placebo-controlled study at Washington University in 56 subjects showed a 13% decline in abdominal fat (fat that drives resistance to insulin) measured by MRI with 50 mg of DHEA per day at bedtime, along with improved sugar control and lower insulin levels. Pectin, beta-glucan Pectin is the soluble fiber in citrus rinds, green vegetables, and apples, also available as a supplement. Beta-glucan is the soluble fiber of oats and is also available as a supplement. Both are wonderful fibers that provide feelings of fullness, lower cholesterol, slow release of sugars, and can yield modest weight reduction. A USC study in 573 subjects using carotid ultrasound showed that greater intake of healthy fibers like pectin and beta-glucan is associated with less carotid plaque growth. Folic acid, vitamins B6 and B12 Dr. Daniel Hackam at the Stroke Prevention and Atherosclerosis Research Centre in Ontario conducted a study using carotid ultrasound in 101 participants treated with folic acid 2.5 mg, vitamin B6 25 mg, and B12 250 mcg per day. Treatment resulted in plaque reduction, especially when homocysteine levels exceeded 14μmol/l at the start, compared to untreated participants who experienced substantial plaque growth. An attempt to clarify the role of homocysteine treatment was made through a National Institute of Health-sponsored study of stroke prevention. 3680 participants with a prior history of stroke were enrolled and given either a “low-dose” (20 mcg folic acid, 0.2 mg B6, 6 mcg B12) or a “high-dose” (2.5 mg folic acid, 25 mg B6, 400 mcg B12) regimen. Although starting homocysteine levels showed a graded association with stroke risk (higher homocysteine levels predicted greater stroke risk), the treatment groups experienced, on average, only a 2 μmol drop in homocysteine levels and no reduction in stroke risk over two years. The study investigators as well as critics have suggested that the study failed due to an insufficient treatment period and that the doses were too low. (The doses we use in our plaque reduction program are folic acid 2.5–5.0 mg, B6 50–100 mg, B12 1000–2500 mcg.) L-arginine L-arginine can be used to overpower the adverse effects of ADMA. L-arginine is emerging as an important carotid plaque-reversing tool. Early reports in animals showed that l-arginine completely halted growth of aortic plaque, and did so more effectively than lovastatin (a cholesterol-lowering drug). In humans, L-arginine reduces blood pressure, abnormal constriction of carotid and coronary arteries, blocks entry of inflammatory cells into plaque, increases sensitivity to insulin, and heightens exercise capacity. Following coronary angioplasty or stent placement, l-arginine results in up to 36% reduction in plaque growth. The average American takes in 5400 mg of l-arginine through food every day. Supplementing with doses of 3000–12,000 mg per day has proven useful to correct many of these phenomena. (We use a dose of 6000 mg of l-arginine powder, twice a day on an empty stomach, dissolved in water, for our plaque regression program.) Does this result in a reduction of stroke risk? The emerging data suggest that l-arginine is likely to exert a powerful plaque-reducing and stroke-preventing benefit, but we await more clinical trial data. Conclusion Reducing stroke risk by reversing carotid and aortic plaque is becoming an everyday reality, with better tools becoming available. To know whether you’re at risk, the best and most available imaging tool is carotid ultrasound, aiming to identify intimal-medial thickness >1.0 mm, or carotid plaque. Any degree of calcification of the aorta, such as on a CT heart scan, is another useful measure of risk. Treatment to reduce risk is multi-faceted but is based on examining all your sources of risk, including metabolic syndrome, small LDL, lipoprotein(a), and C-reactive protein. Fish oil is the one absolutely crucial ingredient in any stroke prevention program. Other supplements can be used in a targeted fashion, depending on the causes identified for your carotid or aortic plaque. Ideally, repeat scanning of your carotids should be done sometime after your program has begun to assess whether you’ve successfully achieved reversal of plaque growth. pnis enlargement procedure where to buy vigrx manual penis elargement exercise plastic surgery pnis enlargement penis enhancement forum home penis enhancement real penis enlargment penis enlagement tool

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Many physicians recommend EKGs as a preventative-screening tool for those with a family history of heart disease. While a healthy person does not need an EKG as a part of an annual exam, many physicians will recommend an EKG if they have concerns. If a patient complains of chest pain, palpitations or other indicators of heart problems, the physician will likely recommend an immediate EKG test. Depending on the severity of the situation, your doctor may refer you to a local testing center immediately or ask you to schedule the next available appointment. An abnormal EKG is determined by comparing the results of your EKG graph with a standard or normal heart graph. Spikes and dips within the graph are referred to as P, QR and PR and other similar acronyms. Normal EKG readings show a slight flat-dip in between contractions and relaxations. If these flat-dips are not present, it may be an indication of a more serious problem. Normal EKG readings will have spikes and dips too. Myocardial defects, heart valve disease, enlargement of the heart, inflammation of the heart, coronary artery disease, and past, pending or impending heart attacks are only a few of the problems that EKG’s can help to detect. The conditions in which the EKG is performed can also have an impact on the accuracy of the results. Some heart problems are not present all of the time and therefore may not appear in EKG results. In cases where heart problems are suspected but not detected on the EKG, a Holter monitor may be recommended. This monitor is worn, usually for a period of 24 to 48 hours and serves as a type of mini-EKG test. The patient wears the monitor at home and it continuously records heart activity. Doctors also recommend that the patient be relaxed during the exam because any muscle trembling or contractions can alter the results and produce an inaccurate reading. Many people are surprised to learn that they have had an abnormal EKG reading. What is even more surprising is that when presented with abnormal EKG results, some doctors do not seem concerned. It doe not necessarily mean they are inadequate or uncaring physicians, it is more likely they believe something else has caused the abnormal reading. Most will want to pursue further testing or another EKG. Sometimes an event as simple as low blood sugar can have an altering affect and produce false EKG readings. Other times, abnormal EKGs require further testing to determine what, if any, problems actually exist. penis enlargement surgery picture prosolutionpills home penis enhancement pennis enlargement before and after photo free penile enlargment technique homemade pnis enlargement penile enlargement photo pnis enlargement surgery photo blood erection vimax penis pills

Breast enlargement cream is a non-invasive method and natural method of breast enlargement. The ingredients of the cream are similar in composition and serve the same purpose as that of breast enhancement pills but are found in smaller amounts. Some of the ingredients used are sabal, damiana, dong quai, blessed thistle, kava, dandelion root, oat bran, and wild yam. Manufacturers claim that the use of breast enlargement cream can increase the size of the breasts by several cups and can help women to achieve fuller breasts with firmer tissues. Mothers who have lost their breast shape after pregnancy can also use the cream to give firmness. The cream promotes the growth of breast tissues by naturally balancing the female hormones. Many of the creams manufactured also act as a supplement to pills and work to enhance or sustain the changes achieved through the pills. The cream also has a cosmetic affect as its application boost the total appearance of the breasts and makes them firmer and smoother. The cream is to be applied twice a day consistently for a period of 3 to 6 months to achieve a multiple-cup increase. The results may differ from one individual to another, and women with smaller breasts may take more time to attain a sizeable increase. The manufacturers claim that some results can be visible within the first 4 weeks of its use. It is argued that breast enlargement cream is not so effective when used in isolation. Its effectiveness can be substantial if it is used in combination with breast enlargement pills and regular breast enhancing exercises. The risk of using breast enlargement cream is unknown. However some individuals may develop allergic reactions to the ingredients used. Various manufacturers use different ingredients in the formulation of the cream, so it is important to check out the product with the doctors or health professionals to understand the benefit of each ingredients and the risk inherent in using such a product. Individuals who are allergic to herbal compounds must not use the product. homemade penile enlargement pnis enlargement surgery photo penis enargement cream vimax male penis enlargement does penis enlargment work permanent penis enhancement manual penis enlagement exercise pennis enlargement procedure blood erection vimax penis pills

The penis enlargement market is growing by the day as more and more men join the trend that’s slowly moving into the mainstream. Men worried about the size of their penises and men who are doing just fine, but want to gain a little extra length, are all starting on penis enlargement. But the question is: how many of them actually manage to successfully finish their enlargement programs? And what are the causes of failures reported by these men. Well, the top reasons why men fail in their quest for bigger penises are boredom and lack of motivation. You have to realize that many men fail simply because they aren’t motivated enough. They are enthusiastic about starting their penis enlargement exercises, but lose interest after some time. Some don’t have the willpower to stick to the program and get depressed over the lack of results. Others are simply bored by everything that doesn’t provide results within five minutes. Still others decide that penis enlargement is too much trouble. Another big issue, one that plagues committed penis enlargement customers, is the incorrect assessment of workout intensity. In time, some users find a certain performance pace in their workouts and fail to realize that workout intensity should increase over time. The intensity of a beginner’s workout is no longer suitable after two months of workouts. And at the opposite pole are the guys who rush straight into a high-intensity workout without going through the beginner phase. These people always manage to injure themselves by trying to cheat time and obtain results way ahead of schedule. Both these groups end up in the demotivation zone simply because they are out of sync with the proper workout schedule. In a similar situation are those who aren’t aware that they should change their routines. As the body adapts to the exertion, heavily used exercises become less and less effective and should be replaced with new ones. There are plenty to choose from, so that shouldn’t be a problem. Keep in mind that once you’ve squeezed everything from an exercise, it’s time to move on to other routines. It’s the only way those inches will start adding. Not paying proper attention to advice offered by penis enlargement experts is also a big problem. For instance, men who engage in penis enlargement exercises are told time and again that they should abstain from sex for two or three hours after finishing a workout session. The penis needs time to heal and rebuild broken tissues and further exertion is likely to interfere with this process. Still, some people refuse to follow this piece of advice. While I do understand that it’s a shame to waste a perfectly good hard-on, I also know that advice coming from experts should be heeded. Not paying proper attention to exercise instructions is even worse of a problem. Although the exercises are fairly easy to follow, especially with a video demonstration attached, some people fail to get them right. This is the reason behind most of the injuries reported by penis enlargement users. People failing to perform exercises as shown or trying to improve on the design. There are also people who don’t know when to stop and think they can tank through the pain and make it on the other side through sheer willpower. Although a certain level of pain is normal during penis enlargement exercises, intense pain is a clear sign that you should stop whatever it is you’re doing and let your penis recover. And the last issue on my list of mistakes is warming up and down. This is yet another thing that men are told they must do before and after workout sessions. Still, some men choose to skip this part of the program. Warming up and down is very important to preparing the tissues for the coming workout and for the healing and rebuilding process. Although some men can do without the warming up and down, most men should follow these procedures. It is in their best interest. So there you have it. A list of common mistakes people make and which hinder their efforts to add those extra inches to their penises. Forewarned, you can avoid these pitfalls and keep on the path to safe and effective penis enlargement. Have fun and stay safe. top penis elargement pills safe penis enlagement pennis enlargement before and after photo penis enlargement without pills cheap penis enargement pennis girth enlargement does vig rx really work vig rx oil blood erection vimax penis pills

"Vanilla" is a term used frequently by those, into more or less alternative lifestyles, for those, who - according to them - are not. The question however is, does "vanilla" actually exist and isn't vanilla actually the new sexual minority? Let's face it: the we-get-married-live-happily-ever-after have-sex-2.5-times-per-week couple is rapidly becoming a rare phenonomemum in our modern society. Sex before marriage (almost unthinkable fifty years ago) is the current norm. Usually with multiple partners. Especially in the United States teenage mothers still in high school is no longer an exception (not meaning to say that this a a good sign!). More than half of the United States marriages end up in a divorce and this has brought us a new term: "serial monogamy". "Till death do us part" is a vow not many people will stick to these days and if they do it is far from uncommon to engage in such things as threesomes, swinging or simply do what modern day therapists call "spicing up your sexlife". Is all this "uncommon" or "abnormal"? In terms of evolution actually not. In the end the human species is a mamal and monogomous mamals are indeed very rare. To a point there is evolutionairy logic to becoming pregnant as soon as you can. Why else would nature create fertility at a young age? Give a bonobo (an ape) a pencil and it is likely to draw a penis (yes they can and will, as scientific research has proven). And on the evolutionary calender of mankind things such as monogamy or even marriage make up for less than the last five minutes of that calender. Can you honestly say you have never engaged in anything kinky? There is no scientific research to provide a solid answer to that question. But my guess is that in our modern Western society very few people can honestly say they never have. In the current Internet age many - if not most - people at the very least have taken a (sneak)peak at porn-sites, engaged in an erotic chat or even exchanged some steamy email. Exposed belly buttons and navel piercings are common fashion statements and so are spiked leather collars, high heels, short skirts, revealing blouses and push-up bras. Not mention botox and breast implants. Yes, a breast implant is a form of kinky sex. In the kinky world it is called body manipulation and in fact no different from a tattoo, a piercing, a branding or a scar. What actually is the difference between wearing make up and wearing a sexy leather skirt? The answer is: your own perception - nothing else. There's an old joke: "A dirty mind is a joy forever". As in most jokes there is wisdom in this one. The brain is the biggest sex organ. Some would argue it actually is the only one. And that is the whole point. Your own perception is what drives you. And if you want to "hip", "avant garde" or tendsetter? Well, maybe becoming "vanilla" again might be a wise choice.