Re: Just Started AndroGel

[Guest guest]

On Tue, 15 Aug 2006 03:39:54 -0000, you wrote:

>I tested 319 total T the last time I was tested and the lab has 350

>as the bottom of their normal range. The new urologist that I am

>seeing agreed to try me on AndroGel 5g to start with. I started it

>a week ago Saturday on the 5th. I don't feel any different. From

>what I have read I am not surprised, because it seems that few get

>the desired response from 5g. I weigh 215 so I am not a little guy

>and I don't expect it to be adequate. Here's the thing that causes

>me to post - my urologist wants to wait 8 weeks to test me. I asked

>(through the nurse practitioner) if I could be tested in two weeks

>like is on the product info (and I have read in several posts) and

>was told the doc wants to wait the 8 weeks. Is there any reason to

>wait the 8 weeks? Here is the response from the nurse practitioner -

>

>

>I spoke with Dr. xxxxx this AM. He prefers to wait for the original

>time period because symptom relief comes slowly regardless of the

>rise in level. Due to potential side effects, we wouldn't want to

>over shoot our dosage. Hang in there.

>

>So I started an email response, but feel it won't do any good. What

>do you do in a case like this? Am I wrong to feel that I want

>tested sooner because I may be missing out on feeling better? Is

>there really a reason to wait?

>

>Thanks for any thoughts you may have!

Did he run E2, LH, FSH, Prolactin?

It scares me how many docs just write a scrip for T on seeing a low T

number. Please bring him a copy of the AACE guidelines

http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf

and read up yourself what a proper round of diagnosis tests should

include BEFORE starting TRT.

But yes at your size I doubt 5 g packets will do much. I was on 1 and

a 1/2 and it worked for me - for a time. (They make a pump model for

1/2 doses and doubles.)

________________

I am human; nothing in humanity is alien to me.

Terence

[Guest guest]

Thanks retrogrouch and Phil Georgian!!

I had requested the tests to be done outlined in a post by Phil.

They wouldn't do all of them but here's the results that I just got

today (test performed 7/29/06).

Ultra TSH 1.18

FSH 3.4

LH 3.8

Cortisol 9.9

Prolactin 5.6

PSA 2.0

Estrogen (fractionated) 50

Estradiolm, serum 21

Estrone 29

Sex steroid binding globulin 20

Testosterone 319

Free Testosterone 72.7

% Free Testosterone 2.3

The only other time I was tested was in May 2005 and they got

224NG/DL for total T and I was told I was low-normal. I protested

and they referred me to two different urologists that didn't work

out. I then got the general practitioner to refer me to another

urologist and finally got an agreement that I am low on T.

I look forward to any response that anyone may have!!

>

> >I tested 319 total T the last time I was tested and the lab has

350

> >as the bottom of their normal range. The new urologist that I am

> >seeing agreed to try me on AndroGel 5g to start with. I started

it

> >a week ago Saturday on the 5th. I don't feel any different.

From

> >what I have read I am not surprised, because it seems that few

get

> >the desired response from 5g. I weigh 215 so I am not a little

guy

> >and I don't expect it to be adequate. Here's the thing that

causes

> >me to post - my urologist wants to wait 8 weeks to test me. I

asked

> >(through the nurse practitioner) if I could be tested in two

weeks

> >like is on the product info (and I have read in several posts)

and

> >was told the doc wants to wait the 8 weeks. Is there any reason

to

> >wait the 8 weeks? Here is the response from the nurse

practitioner -

> >

> >

> >I spoke with Dr. xxxxx this AM. He prefers to wait for the

original

> >time period because symptom relief comes slowly regardless of the

> >rise in level. Due to potential side effects, we wouldn't want

to

> >over shoot our dosage. Hang in there.

> >

> >So I started an email response, but feel it won't do any good.

What

> >do you do in a case like this? Am I wrong to feel that I want

> >tested sooner because I may be missing out on feeling better? Is

> >there really a reason to wait?

> >

> >Thanks for any thoughts you may have!

>

>

> Did he run E2, LH, FSH, Prolactin?

>

> It scares me how many docs just write a scrip for T on seeing a

low T

> number. Please bring him a copy of the AACE guidelines

>

> http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf

>

> and read up yourself what a proper round of diagnosis tests should

> include BEFORE starting TRT.

>

> But yes at your size I doubt 5 g packets will do much. I was on 1

and

> a 1/2 and it worked for me - for a time. (They make a pump model

for

> 1/2 doses and doubles.)

>

> ________________

> I am human; nothing in humanity is alien to me.

> Terence

>

[Guest guest]

Phil,

They didn't give units on everything, but here is what I have.

FSH 3.4 MIU/ML range 1.3 - 19.3

LH 3.8 MIU/ML range 1.2 - 8.6

Cortisol 9.9 MCG/DL range 8.7 - 22.4

Testosterone 319 (no units given) range 350 - 890

Can you tell from the above units what units this lab uses and

evaluate all my test results?

Can you tell from what I have given you if they jumped the gun on

starting the TRT? Should they have done more testing or tried

something else first?

Since they have started me, I wish I knew the right thing to say to

the nurse practitioner to get her to get the doctor to go ahead and

have the two week follow up test done Saturday. She's stuck in the

middle between me trying to get the test done per the AndroGel

literature and what the Doc is telling her to do.

Thanks for any help!!

> >

> > >I tested 319 total T the last time I was tested and the lab has

> 350

> > >as the bottom of their normal range. The new urologist that I

am

> > >seeing agreed to try me on AndroGel 5g to start with. I started

> it

> > >a week ago Saturday on the 5th. I don't feel any different.

> From

> > >what I have read I am not surprised, because it seems that few

> get

> > >the desired response from 5g. I weigh 215 so I am not a little

> guy

> > >and I don't expect it to be adequate. Here's the thing that

> causes

> > >me to post - my urologist wants to wait 8 weeks to test me. I

> asked

> > >(through the nurse practitioner) if I could be tested in two

> weeks

> > >like is on the product info (and I have read in several posts)

> and

> > >was told the doc wants to wait the 8 weeks. Is there any reason

> to

> > >wait the 8 weeks? Here is the response from the nurse

> practitioner -

> > >

> > >

> > >I spoke with Dr. xxxxx this AM. He prefers to wait for the

> original

> > >time period because symptom relief comes slowly regardless of

the

> > >rise in level. Due to potential side effects, we wouldn't want

> to

> > >over shoot our dosage. Hang in there.

> > >

> > >So I started an email response, but feel it won't do any good.

> What

> > >do you do in a case like this? Am I wrong to feel that I want

> > >tested sooner because I may be missing out on feeling better?

Is

> > >there really a reason to wait?

> > >

> > >Thanks for any thoughts you may have!

> >

> >

> > Did he run E2, LH, FSH, Prolactin?

> >

> > It scares me how many docs just write a scrip for T on seeing a

> low T

> > number. Please bring him a copy of the AACE guidelines

> >

> > http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf

> >

> > and read up yourself what a proper round of diagnosis tests

should

> > include BEFORE starting TRT.

> >

> > But yes at your size I doubt 5 g packets will do much. I was on

1

> and

> > a 1/2 and it worked for me - for a time. (They make a pump model

> for

> > 1/2 doses and doubles.)

> >

> > ________________

> > I am human; nothing in humanity is alien to me.

> > Terence

> >

>

>

>

>

>

>

>

>

>

>

>

[Guest guest]

Curious to see how his works out for you..I'm in very similar

situation...low-end on T and midrange on LH. Just started Androgel

yesterday. No changes yet. Amazing, been dealing with this for 10

years and now I'm not happy it hasn't been fixed in 1 day. I'm also

on 5mg Androgel - seems most say it isn't enough, but if my pre-

treatment level was 299 and 5mg Andro gets most people to the 500

range - shouldn't I be in the 700's rather quickly. At least until

my own production slows down?

> > >

> > > >I tested 319 total T the last time I was tested and the lab

has

> > 350

> > > >as the bottom of their normal range. The new urologist that I

> am

> > > >seeing agreed to try me on AndroGel 5g to start with. I

started

> > it

> > > >a week ago Saturday on the 5th. I don't feel any different.

> > From

> > > >what I have read I am not surprised, because it seems that

few

> > get

> > > >the desired response from 5g. I weigh 215 so I am not a

little

> > guy

> > > >and I don't expect it to be adequate. Here's the thing that

> > causes

> > > >me to post - my urologist wants to wait 8 weeks to test me. I

> > asked

> > > >(through the nurse practitioner) if I could be tested in two

> > weeks

> > > >like is on the product info (and I have read in several

posts)

> > and

> > > >was told the doc wants to wait the 8 weeks. Is there any

reason

> > to

> > > >wait the 8 weeks? Here is the response from the nurse

> > practitioner -

> > > >

> > > >

> > > >I spoke with Dr. xxxxx this AM. He prefers to wait for the

> > original

> > > >time period because symptom relief comes slowly regardless of

> the

> > > >rise in level. Due to potential side effects, we wouldn't

want

> > to

> > > >over shoot our dosage. Hang in there.

> > > >

> > > >So I started an email response, but feel it won't do any

good.

> > What

> > > >do you do in a case like this? Am I wrong to feel that I want

> > > >tested sooner because I may be missing out on feeling better?

> Is

> > > >there really a reason to wait?

> > > >

> > > >Thanks for any thoughts you may have!

> > >

> > >

> > > Did he run E2, LH, FSH, Prolactin?

> > >

> > > It scares me how many docs just write a scrip for T on seeing

a

> > low T

> > > number. Please bring him a copy of the AACE guidelines

> > >

> > > http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf

> > >

> > > and read up yourself what a proper round of diagnosis tests

> should

> > > include BEFORE starting TRT.

> > >

> > > But yes at your size I doubt 5 g packets will do much. I was

on

> 1

> > and

> > > a 1/2 and it worked for me - for a time. (They make a pump

model

> > for

> > > 1/2 doses and doubles.)

> > >

> > > ________________

> > > I am human; nothing in humanity is alien to me.

> > > Terence

> > >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

Phil,

Thanks for the response and questions.

The test was in the morning. The lab range for cortisol was broken

down into AM specimen or PM specimen. The range of 8.7 - 22.4 was

listed for the AM specimen. So I have to agree with you that I am

low, but that doesn't mean much to me due to my ignorance of

cortisol.

I still haven't noticed much if any change since starting the 5g

AndroGel. On Saturday (right or wrong) I decided to cheat and use

two of the packets. I tried to decide if I felt better or not and

decided that maybe I felt a bit better. It was hard to tell. The

next day (yesterday) I went back to one packet and felt bad all

day. I couldn't get myself to do anything. We had tickets to go to

an event, but I wasn't up to it. I didn't feel better until about

7:00 or 8:00PM.

Does this make sense? Did my higher dose one day and going back to

the prescribed dose the next cause me to crash on my T level? I

can't help but think that that is what happened and that I won't do

that again.

It also makes me think that getting my T level up in the proper

range is that much more important to me, since I think I felt what

it is like to have a dip down lower than my normal low T level. I

just wish I knew how to influence my doc to not make me wait so long

to test me next.

Thanks for the help to those that have posted!

> > >

> > > >I tested 319 total T the last time I was tested and the lab

has

> > 350

> > > >as the bottom of their normal range. The new urologist that I

> am

> > > >seeing agreed to try me on AndroGel 5g to start with. I

started

> > it

> > > >a week ago Saturday on the 5th. I don't feel any different.

> > From

> > > >what I have read I am not surprised, because it seems that

few

> > get

> > > >the desired response from 5g. I weigh 215 so I am not a

little

> > guy

> > > >and I don't expect it to be adequate. Here's the thing that

> > causes

> > > >me to post - my urologist wants to wait 8 weeks to test me. I

> > asked

> > > >(through the nurse practitioner) if I could be tested in two

> > weeks

> > > >like is on the product info (and I have read in several

posts)

> > and

> > > >was told the doc wants to wait the 8 weeks. Is there any

reason

> > to

> > > >wait the 8 weeks? Here is the response from the nurse

> > practitioner -

> > > >

> > > >

> > > >I spoke with Dr. xxxxx this AM. He prefers to wait for the

> > original

> > > >time period because symptom relief comes slowly regardless of

> the

> > > >rise in level. Due to potential side effects, we wouldn't

want

> > to

> > > >over shoot our dosage. Hang in there.

> > > >

> > > >So I started an email response, but feel it won't do any

good.

> > What

> > > >do you do in a case like this? Am I wrong to feel that I want

> > > >tested sooner because I may be missing out on feeling better?

> Is

> > > >there really a reason to wait?

> > > >

> > > >Thanks for any thoughts you may have!

> > >

> > >

> > > Did he run E2, LH, FSH, Prolactin?

> > >

> > > It scares me how many docs just write a scrip for T on seeing

a

> > low T

> > > number. Please bring him a copy of the AACE guidelines

> > >

> > > http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf

> > >

> > > and read up yourself what a proper round of diagnosis tests

> should

> > > include BEFORE starting TRT.

> > >

> > > But yes at your size I doubt 5 g packets will do much. I was

on

> 1

> > and

> > > a 1/2 and it worked for me - for a time. (They make a pump

model

> > for

> > > 1/2 doses and doubles.)

> > >

> > > ________________

> > > I am human; nothing in humanity is alien to me.

> > > Terence

> > >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

Wow - thanks for all the info. I had a long day today and have not

had as much time as I would like to go through all of this. I will

though.

I took my temp and it is 97.8 with a thermometer like the one you

use. I have gotten low readings like that much of the time in the

past. When I have asked about the low reading before, I have been

told that different people have different " normal " temperatures.

From what I read in the link you posted, that is not really true.

I'll have to plot my temps. I just took it again and got 97.5.

I don't feel so great about misleading the doc. You might be right

that that is what I should do (tell a little white lie), but even

though we have not started out so great, I'm hoping to develop a

relationship where he feels like working with me to get me fixed up.

Thanks for all the info!! You help a lot people with your knowledge.

> > > >

> > > > >I tested 319 total T the last time I was tested and the lab

> has

> > > 350

> > > > >as the bottom of their normal range. The new urologist that

I

> > am

> > > > >seeing agreed to try me on AndroGel 5g to start with. I

> started

> > > it

> > > > >a week ago Saturday on the 5th. I don't feel any different.

> > > From

> > > > >what I have read I am not surprised, because it seems that

> few

> > > get

> > > > >the desired response from 5g. I weigh 215 so I am not a

> little

> > > guy

> > > > >and I don't expect it to be adequate. Here's the thing that

> > > causes

> > > > >me to post - my urologist wants to wait 8 weeks to test me.

I

> > > asked

> > > > >(through the nurse practitioner) if I could be tested in

two

> > > weeks

> > > > >like is on the product info (and I have read in several

> posts)

> > > and

> > > > >was told the doc wants to wait the 8 weeks. Is there any

> reason

> > > to

> > > > >wait the 8 weeks? Here is the response from the nurse

> > > practitioner -

> > > > >

> > > > >

> > > > >I spoke with Dr. xxxxx this AM. He prefers to wait for the

> > > original

> > > > >time period because symptom relief comes slowly regardless

of

> > the

> > > > >rise in level. Due to potential side effects, we wouldn't

> want

> > > to

> > > > >over shoot our dosage. Hang in there.

> > > > >

> > > > >So I started an email response, but feel it won't do any

> good.

> > > What

> > > > >do you do in a case like this? Am I wrong to feel that I

want

> > > > >tested sooner because I may be missing out on feeling

better?

> > Is

> > > > >there really a reason to wait?

> > > > >

> > > > >Thanks for any thoughts you may have!

> > > >

> > > >

> > > > Did he run E2, LH, FSH, Prolactin?

> > > >

> > > > It scares me how many docs just write a scrip for T on

seeing

> a

> > > low T

> > > > number. Please bring him a copy of the AACE guidelines

> > > >

> > > > http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf

> > > >

> > > > and read up yourself what a proper round of diagnosis tests

> > should

> > > > include BEFORE starting TRT.

> > > >

> > > > But yes at your size I doubt 5 g packets will do much. I was

> on

> > 1

> > > and

> > > > a 1/2 and it worked for me - for a time. (They make a pump

> model

> > > for

> > > > 1/2 doses and doubles.)

> > > >

> > > > ________________

> > > > I am human; nothing in humanity is alien to me.

> > > > Terence

> > > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

[Guest guest]

I emailed the nurse practitioner a couple of times and finally got

her to issue the lab order. I'm happy that she did that, but she

only made the order for total T. I guess since I don't really feel

that the gel has significantly changed my T level, there is no need

for testing anything other than T at this time. I'll post my

results when I get them next week and also what the doc says.

> Wow - thanks for all the info. I had a long day today and have

not

> had as much time as I would like to go through all of this. I will

> though.

>

> I took my temp and it is 97.8 with a thermometer like the one you

> use. I have gotten low readings like that much of the time in the

> past. When I have asked about the low reading before, I have been

> told that different people have different " normal " temperatures.

> From what I read in the link you posted, that is not really true.

> I'll have to plot my temps. I just took it again and got 97.5.

>

> I don't feel so great about misleading the doc. You might be right

> that that is what I should do (tell a little white lie), but even

> though we have not started out so great, I'm hoping to develop a

> relationship where he feels like working with me to get me fixed

up.

>

> Thanks for all the info!! You help a lot people with your

knowledge.

>

[Guest guest]

I got the results today from the test done Saturday. My T level is

down to 161.

To recap - my first test about a year ago was 224 (this was done at

another lab - I mistakenly posted it was 242). The test done a few

weeks ago was 319 at the new lab (ref. range 350-890). I was started

on 5g AndroGel and have definately not felt any better and some days

for sure worse.

With the new test result coming in at 161 total T, I was given the go

ahead to change to 10g AG/day.

I must say from all the posts that I have read and my results to date,

I am very skeptical that the AG is going to do the trick. My best

hope at the moment is that it will get me in range for a while, but I

have just not read about many that have long term good results from

AG. I hope this is because when someone does get good results they

are no longer active on the forums.

Has anyone had good long term results on AG?

I'm going to write an email to the nurse practitioner requesting that

I be retested in two weeks this time. I will also ask to have all the

recommended testing, not just T. I'm going to bring up my low

cortisol level also, like Phil pointed out.

Any suggestions are more than welcome!

>

> I emailed the nurse practitioner a couple of times and finally got

> her to issue the lab order. I'm happy that she did that, but she

> only made the order for total T. I guess since I don't really feel

> that the gel has significantly changed my T level, there is no need

> for testing anything other than T at this time. I'll post my

> results when I get them next week and also what the doc says.

>

[Guest guest]

My prolactin tested at 5.6 - they didn't provide units or a lab

range.

My E2 tested at 21 - same here - no units or range provided. If

they use the same units and ranges like other posters' labs, my E2

is right were I want it - right? This was before the start of AG.

The docs have not mentioned an MRI. I am extremely fortunate to be

able to get an MRI for free, I just have to drive 7 hours. Maybe

this is just my ignorance, but I have not felt terribly motivated to

get the MRI. I now believe that I have had low T for something like

thirty years now. Doesn't seem like a tumor to me. Am I wrong?

Thanks!!

>

> >

> >With the new test result coming in at 161 total T, I was given

the go

> >ahead to change to 10g AG/day.

>

> Have they tested prolactin and E2? Have they done an MRI?

>

> You should most likely not start on TRT until these are done.

>

> ________________

> I am human; nothing in humanity is alien to me.

> Terence

>

[Guest guest]

Your post together with the others I have read lead me to believe that

I will be giving myself shots in the near future. I kinda want to

skip right to them, but I guess I will try to wait and do what the doc

wants for now and then press for the shots when it doesn't work out.

I'm thinking that if the 10g AG gets me barely into the normal range,

the doc is going to think he has done his job. When I sent the email

to the nurse practitioner stating that I ultimately wanted to be in

the upper one third of the labs' range, I didn't get a response to

that part of the email. We'll see.

Thanks for the post!

>

> Hey Dave - we have a similar history. I was first diagnosed at 225

and told that was OK. Went another year - feeling like crap with no

sex drive and ED. Tested again at 180. Put on AG and did not absorb.

Started at 5 g a day and my T was 188 (no change). Due to my insurance

I had to try the patch -that was another bad story - After finding

this forum I discussed injections with my Doc - he agreed and it has

been the best therapy for me. Also had to get on arimidex due to high

E2. Some people don't absorb it well and best I can tell is even at 10

g AG a day, your T levels will still not be where you need them based

on your initial indications. It works for some but not all. It took me

a year to get where I feel good 95% of the time - still tweeking.

[Guest guest]

Dave: I was originally at 250 but was told that was OK, also.

I'm suspicious that when your T is that low, Androgel won't do the

trick. At 10g of 1% per day, I was getting my T level up to 775,

but didn't feel much better, and still had NO sex drive. It helped

to switch from Androgel to a more concentrated cream made by a

compounding pharmacist, which made me more hairy with occasional

nocturnal erections. But once I switched to injectable after being

on the gel/cream for a year, everything changed. Suddenly I had sex

drive and my energy levels came back. Currently, my E2 level is 50

but now I'm being told that's OK too. I feel I have no choice but

to correct it on my own with DIM and give the reports back to the

doctors so they have a record of what's going on.

-- RedBear

> >

> > I emailed the nurse practitioner a couple of times and finally

got

> > her to issue the lab order. I'm happy that she did that, but she

> > only made the order for total T. I guess since I don't really

feel

> > that the gel has significantly changed my T level, there is no

need

> > for testing anything other than T at this time. I'll post my

> > results when I get them next week and also what the doc says.

> >

>

>

>

>

>

>

> ---------------------------------

> Stay in the know. Pulse on the new .com. Check it out.

>

>

[Guest guest]

I changed to 10g of AndroGel two weeks ago and just got blood work

done. The doc only made the order for total T. The result was

331. I hope it was not a big deal that I had the blood drawn at

about 8:00 at night.

Even though my doc seems to be against injections, should I push for

them or seek another doc? Any suggestions on other options, creams,

etc? If I am learning correctly, with only an increase this small,

I surely wouldn't benefit from an AI would I? Pre TRT my E2 tested

at 21.

I found a local doc on the Testosterone Tuneup list and gave them a

call. Maybe I used the wrong approach, but I said that I would like

to talk to the doc. I said I would be happy to make an appointment

in order to do so. The receptionist or whatever said that I would

have to have my records sent over and become a patient. I asked if

I couldn't just chat first and was told that it was all (become a

patient) or nothing.

How do you go about getting your doc to work with Dr. ? I'm

actually asking about the psychology involved. Doctors tend to have

big egos. How has it worked for others to get Dr. involved

without crushing that big ego and the doc telling you (even if he is

not this blunt) that he doesn't need any outside help because he

knows what he is doing?

As always, thanks for the help!

[Guest guest]

I got my MRI done Sunday and it is negative. I am very fortunate to

have a brother that owns an MRI clinic - that's why it was done on a

Sunday.

With the MRI coming up negative, that has me trying to figure out

why my T, LH, and FSH are low. I still have a lot to learn, but I'm

thinking that maybe it is like Phil has said that I need to get my

cortisol up. I tested at 9.9 (range of 8.7 - 22.4) on an AM test.

Phil just posted a link

(http://personal.lig.bellsouth.net/w/u/wurmstei/) and I read some of

it (Thanks Phil!!). The part where low cortisol was discussed and

having aching feet and sleep apnea/snoring realy caught my eye. My

feet get to aching if I am on them for a few minutes. I have been

diagnosed with sleep apnea after an overnight stay at a sleep clinic.

Should I get some Isocort and try that or wait for my appointment

with the doc next week and roll the dice with him? I plan on giving

him one more shot before I jump ship on him.

Any thoughts would be appreciated!!

>

> >I changed to 10g of AndroGel two weeks ago and just got blood

work

> >done. The doc only made the order for total T. The result was

> >331. I hope it was not a big deal that I had the blood drawn at

> >about 8:00 at night.

> >

> >Even though my doc seems to be against injections, should I push

for

> >them or seek another doc? Any suggestions on other options,

creams,

> >etc? If I am learning correctly, with only an increase this

small,

> >I surely wouldn't benefit from an AI would I? Pre TRT my E2

tested

> >at 21.

>

> I don't understand why he opposes injections. They're about $2000

> cheaper over a year and work better for most - if done at least

weekly

> and with some E2 management.

>

> ________________

> I am human; nothing in humanity is alien to me.

> Terence

>