#pcos medication in usa

[pcosdiva123]

Can I get pregnant if I have PCOS?

For many women diagnosed with Polycystic Ovary Syndrome (PCOS), one of the most pressing questions is, Can I get pregnant if I have PCOS The short answer is yes, many women with PCOS can conceive and have healthy pregnancies. However, due to the condition's impact on ovulation and hormonal balance, some women may face challenges along the way. At PCOS Diva, we are dedicated to helping women navigate these challenges with the right tools, support, and information.

How Does PCOS Affect Fertility?

PCOS is one of the most common causes of infertility because it disrupts regular ovulation. Ovulation occurs when the ovaries release a mature egg, ready for fertilization. In women with PCOS, hormonal imbalances—such as elevated levels of androgens (male hormones) and insulin resistance—interfere with the normal development and release of eggs. This can lead to irregular periods or anovulation (lack of ovulation), making it more difficult to conceive.

Improving Fertility with PCOS

While PCOS can complicate fertility, it is highly manageable with the right approach. Many women achieve pregnancy by making targeted lifestyle changes and, in some cases, using medical interventions. Here’s how:

Lifestyle Modifications

Healthy Diet: A low-glycemic, nutrient-dense diet helps regulate blood sugar and improve insulin sensitivity. Foods such as lean proteins, whole grains, vegetables, and healthy fats are beneficial.

Regular Exercise: Moderate exercise like walking, swimming, or yoga can improve ovulation and reduce stress.

Weight Management: Even a modest weight loss of 5-10% can significantly improve ovulation and fertility in women with PCOS.

Tracking Ovulation Understanding your menstrual cycle and identifying ovulation days are key. Tools like basal body temperature tracking or ovulation predictor kits can help women with PCOS pinpoint their fertile window.

Medical Treatments For women who need additional support, fertility treatments can be highly effective:

Ovulation-Inducing Medications: Drugs like Clomid (clomiphene citrate) or letrozole stimulate the ovaries to release eggs.

Insulin-Sensitizing Medications: Metformin, often prescribed to manage insulin resistance, can regulate cycles and improve ovulation.

In Vitro Fertilization (IVF): For some women, IVF may be an option if other treatments are unsuccessful.

Supplements and Alternative Therapies Supplements like inositol, vitamin D, and omega-3 fatty acids have been shown to support hormone balance and improve ovulation.

Ensuring a Healthy Pregnancy

Once pregnant, women with PCOS may need extra care to reduce the risk of complications such as gestational diabetes or preeclampsia. Regular prenatal visits, blood sugar monitoring, and a healthy lifestyle are essential.

At PCOS Diva we are committed to empowering women with the resources and knowledge they need to manage PCOS and achieve their dream of starting a family. The journey may have its challenges, but with the right strategies and support, a positive outcome is possible. If you’re asking, "Can I get pregnant if I have PCOS?", the answer is a resounding yes—with patience, care, and the right plan, your path to parenthood is within reach.

[eponadolls]

BJD Sales

Hi everyone! I will have several big expenses over the summer (wisdom tooth removal, newer car, potential ADHD and pcos evals/diagnoses, etc) and I want to make sure they are as... least-impacting as possible on my savings, especially since most are medical and I have no idea how much my insurance is actually going to cover... so any reblogs and shares are always appreciated!

Most things will be cross-posted on Den of Angels, Instagram, and Facebook. Additional information will be under the cut. I ship from the USA and due to postal concerns, I can only send the large, high-value packages within the USA right now.

Allergen warning: I live in a pet-friendly, non-smoking household near a corn mill.

Harucasting Smile Maji head: She’s some kind of tan resin, but I don’t 100% remember which one. Her previous owner split the head and body so the coa went with the body. I remember her previous owners name & email, but I don’t recall their instagram handle. Maji has thankfully NOT been recasted so I do not worry about her legitimacy, but I wanted to be upfront about that detail. Her magnets need to be reglued and she still has faceup residue. As with any of my Harucasting dolls, in respect to Haru’s wishes, I will only sell his dolls to pro-artist/anti-recast individuals.

$100 + shipping

5stardoll Elf Elaine: She was painted by her previous owner and given a mani-pedi which is chipping as well as pretty purple body shimmer. Her face still has faceup residue on it. She’s really cute but I need to make room — I am willing to sell her head separately, though. According to her card of authenticity she was produced in late 2018. I believe she is in normal pink skin.

$170 + shipping

Latidoll Blue Yern:

Yern is a slim MSD sized doll and the Blue (MSD) line has been long discontinued. Yern still has her coa and Latidoll manual, as well as the emblem in and outside of her head. I am not sure of the specifics but her torso has had some kind of mod job for mobility reasons?

Yern is from early 2009 and has certainly yellowed, but her yellowing appears to be consistent. Yern would probably benefit from a restringing with thicker elastics but I can get her to pose and stand just fine. Her s hooks were replaced and she has traditional/standard bjd s hooks in her wrists and ankles. For whatever reason one elbow likes to stay slightly bent. Yern will be shipped UNSTRUNG so that would be a good opportunity for her elastics to be changed; she still has an o hook for her head.

Her faceup is holding up really well considering it is quite old but please be aware that it is old, has some wear, and it is not factored into the price I am selling Yern at. The biggest sign of wear I noticed as a small dark streak near her temple.

She has some damage near her foot/ankle. Considering her age I think she has been holding up really well.

$100 + shipping

Dollzone MSD Girl Body: normal pink resin. Arrived from Alice collections in late 2022, spent most of its time in the box. Asking $200 + shipping.

Harucasting Big Geuru: She is in neul medium tan. She has a face up by @tonocha331. She has an extra pair of hands and comes with her box and card of authenticity. She will come without clothes or eyes.

She has some small s hook scratches in one wrist from a previous owner and several small scratches on her belly. Her face up seems to be in overall good condition other than three shiny spots on the side of her head. $550 + shipping

Logandolls Primrose: Primrose in light tan (coffee) with additional heel feet (strung) and an extra pair of hands. She does not come with a company box but she has a card of authenticity and comes with a blanket that I believe logandolls made for her. Received in a trade from my friend @groovyblueworld! She will NOT come with a pair of eyes. If desired, I can ship her in an old Dollzone company box for extra protection. Ordinarily she would cost $480 new but I am asking $440 + shipping - you basically get the extra hands and feet for free and an extra $10 discount. I can also sell a Flower Primrose faceplate in Resinsoul normal for an additional $40.

$440 + shipping

[thebpdcrybaby]

My name is Sadie and I'm 33 years old with autism and borderline personality disorder. I am not in treatment because I have Medicare for insurance and there are 4+ year waiting lists for therapy. I am on three medications- Effexor, Risperidone, Wellbutrin. I have severe depression, general anxiety disorder, panic disorder, agoraphobia, adjustment disorder, unspecified mood disorder, auditory processing disorder. I have binge eating disorder and struggle with self harm. I'm obese and have always struggled with my weight. I live on my own in an apartment complex, where my mother and five year old autistic son also live. She is raising him now because of my worsening mental health. I have been in a relationship with my son's father for 9 years, it has been a lot of ups and downs. He is my FP (favorite person). He just moved to Arizona due to unfortunate circumstances, so we are now maintaining a long distance relationship. I'm on social security income and live in Pennsylvania, USA. I have heavy suicide ideations. My BPD type is "self destructive." My autism is between level 1 and level 2.

Physical illnesses: morbid obesity, PCOS, hypothyroidism, sciatica on right side plus moderate back pain from spinal degeneration, constant tachycardia

- she/her/hers

- LGBT ally

- extreme leftist

- socialist, anti capitalism

- non religious with interest in The Satanic Temple

- 420 friendly

- Daddy issues

- no ableism

- no fatphobia

- no kink shaming

- no homophobia

- no transphobia

- no racists/Nazis

- no Republicans/Trump supporters

Horror movie fanatic.

Music is life.

Nine Inch Nails, Marilyn Manson, HIM, Linkin Park, Grey Daze, Jack Off Jill, Nirvana, Green Day, Yungblud, Melanie Martinez, Lana Del Rey, Halsey, Buckcherry, Korn, Pearl Jam, Fuel, Pink Floyd, John Mellencamp, She Wants Revenge, Oasis, Pixies, Maroon 5, Sick Puppies, Sixx:A.M., Motley Crue, Aerosmith, Eagles, Creedence Clearwater Revival, Third Eye Blind, Thirty Seconds to Mars, AFI, Violent Femmes, Rise Against, The Struts, In This Moment, The Pretty Reckless, Bring Me The Horizon, Evanescence, Shinedown, Hollywood Undead, Daughtry, The 69 Eyes, Mindless Self Indulgence, Filter, Rob Zombie, Lords of Acid, Matchbox Twenty, Goo Goo Dolls, Papa Roach, Seether, Puddle of Mudd, Bush, Creed, P!nk, Rancid, The Doors, Radiohead, Gin Blossoms, Sex Pistols, My Chemical Romance, Tool, Hole, Good Charlotte, Sublime, Machine Gun Kelly, Miley Cyrus, Noah Cyrus, Avril Lavigne, Lady Gaga, Taylor Swift

My comforts and hyperfixations: Joker, Pete Davidson, Yungblud, Nine Inch Nails, Marilyn Manson, HIM/heartagrams, Bam Margera, The Twilight Zone, The Golden Girls, Home Improvement sitcom, Art the Clown, Jack Skellington, Hello Kitty, Rugrats, the 90s, cemeteries, true crime, splatterpunk, gore, slashers, collecting DVDs and Blu-ray, reading books and Kindle, "alternative" goth, punk, emo, The Sims, casual mobile gaming, poetry, Tate Langdon from American Horror Story season one, American Horror StorIES show on Hulu, Kurt Cobain, Chester Bennington, The Virgin Suicides, Girl Interrupted, Pearl, Euphoria, girlblogging, Sylvia Plath, Franz Kafka

They call me Cry Baby but I don't fuckin care...

Hail to the BPD king, Pete.

[mitsurichan3]

What an incredible let down to wake up to news that /he/ won, again.

Its incredibly hard to see friends be glad when they very much know my backstory, origin as an immigrant and knowing my medical situation with pcos. Knowing Ted cruz will make it harder for me to obtain my medicine for my pcos is a pill that is hard to swallow. Knowing that orange bastard won again means my demographic will be more in danger than in safety. That the racism will get worse. I cant change the color of my skin. I know this country doesnt want me but i do not have an alternative option to live. I do not have opportunies in Guatemala, much less the safety i have here in the USA. yall take that so much for granted. My disabled and POC friends know we are in danger. And it just reinforces it so much more with an election system thats broken.

I dont get it. Whats the point of voting if at the end of the day, when it comes to big elections that will affect the *entire world* just dont matter because the electoral colleges are the ones that decide, not the popular vote? Whats the point of trying to do change for the better when money and bribery and saying hurtful shit is going to win and make the rules to impose on the 95% of the rest of the people around you?

Tell me you DONT care about me without telling me you dont care about me explicitly. Sigh.

Im frustrated, and incredibly terrified.

[healthlaces]

What Are the Four Treatment Options for Female Infertility?

1. Medications:

Clomifene: Stimulates ovulation in women who do not ovulate regularly.

Tamoxifen: An alternative to clomifene for ovulation issues.

Metformin: Particularly beneficial for women with polycystic ovary syndrome (PCOS).

Gonadotrophins: Help stimulate ovulation and improve fertility.

2. Surgical Procedures:

Fallopian Tube Surgery: Repairs blocked or scarred fallopian tubes.

Laparoscopic Surgery: Treats endometriosis, fibroids, and PCOS by removing or destroying abnormal tissue.

3. Assisted Conception:

Intrauterine Insemination (IUI): Sperm is placed directly into the uterus.

In Vitro Fertilisation (IVF): Eggs are fertilized outside the body and then implanted into the uterus.

4. Lifestyle Changes:

Healthy Diet and Exercise: Maintaining a healthy weight can improve fertility.

Stress Management: Reducing stress can positively impact fertility.

Read "The Couple’s guide to Fertility" ebook from Selar App

Download Selar App => https://play.google.com/store/apps/details?id=com.mospeciol.selar

#Infertility #FertilityTreatment #WomensHealth #IVF #IUI #PCOS #HealthyLiving #ReproductiveHealth #Canada #USA #Nigeria #UK #Australia #UAE #MedicalCare #FamilyPlanning #Healthcare #WellnessJourney #StressManagement #HealthyLifestyle

[bestsexologistdoctor]

World top-level Sexologist Doctor in Patna, Bihar for Female Sexual Treatment | Dr. Sunil Dubey

About Female Sexual Hormone (FSH):-

Female Sexual Hormone is also known as female reproductive hormones that play a crucial role in the development, growth, and function of female reproductive system. There are primary female sexual hormones are Estrogen, Progesterone, FSH, LH, Oxytocin, Inhibin, and Relaxin.

These hormones work together to regulate various aspects of female reproductive health including- Menstruation, Ovulation, Pregnancy, childbirth, Lactation, Libido, and Orgasm.  In case of imbalances or abnormalities in these hormones can lead a woman to various health issues such as Infertility, Endometriosis, and Polycystic Ovary Syndrome (PCOS).

Dr. Sunil Dubey, the top-level sexologist doctor in Patna says that mainly, Estrogen and Progesterone are main female sexual hormones. The production of these hormones mainly occurs in ovaries, adrenal gland, and during pregnancy that placenta. These female sexual hormones also influence body weight, hair growth, and bone and muscles growth.

Causes of hormonal imbalance in women:

Female sexual hormone imbalance can be caused by various factors, there are following factors:-

Hormone changes during menopause or Perimenopause in women

Polycystic Ovary Syndrome, PCOS

Thyroid Disorder (Hypothyroidism or Hyperthyroidism)

Adrenal Disorder

Pituitary Gland Problems

Ovarian Cysts or Tumor

Endometriosis

Uterine Fibroids

Early Menopause

Genetics

Stress and Anxiety

Sleep Disorder

Obesity and Weight Changes

Certain Medication like Antidepressant

Alcohol and Smoking

Radiation Therapy

Infection i.e. Pelvic Inflammatory Disease

Autoimmune disorders

Nutritional Deficiency i.e. Vitamin D

Age related hormonal declination

How hormonal imbalance affects sexual life of women:-

The world famous Ayurvedacharya Dr. Sunil Dubey, the best clinical sexologist in Bihar says that generally, the changing in hormonal always affects the life of women in different way. There are following changes in women due to hormonal imbalance:-

Irregular menstrual cycles

Mood changes or swings

Vaginal Dryness

Loss of Libido

Weight gain or loss

Acne

Hair Loss

Fertility Issues

How to balance hormones with natural way of medicine:

Ayurveda and sexology medical science expert Dr. Sunil Dubey says that generally if a woman wants to balance her hormones, she should opt for natural treatment and medicine. Actually, this natural medicine has no side-effects on the body and it balances the body in a natural way.

In his sexology medical science, he has researched on various sexual dysfunctions of women like Sexual Desire Disorder, Sexual Arousal Disorder, Sexual Orgasm Disorder, Vaginismus, Vaginal Dryness, and other sexual problems. After his five years of continuous research, he has successfully discovered the most effective, natural, and pure natural medicines for them.

He practices at Dubey Clinic that is the first Ayurveda and Sexology medical science clinic of Bihar, India. He has been associated with this clinical sexologist profession for more than 35 years. He provides his sexual therapies to more than forty sexual patients every day at this clinic. Both male and female sexual patients come to this clinic to improve their sexual problems.

For the treatment and medication of the hormonal imbalance patients, he says that generally, they need to life style changing, Ayurvedic therapies, and hormone improvement therapy. He provides them the natural system of medication with a health daily life routine.

Regards

Dr. Sunil Dubey, Sr. Sexologist Doctor

B.A.M.S (Ranchi) | M.R.S.H (London)| Ph.D. in Ayurveda (USA)

Helpline No: +91 98350 92586

Venue: Langar Toli, Chauraha, Patna, Bihar

[ivfcostinindiawfs]

IVF Treatment Cost in India - World Fertility Services.

IVF treatment helps couples globally who are facing severe infertility issues and can`t conceive babies naturally on their own. Affordable fertility treatments in India, help couples conceive biological babies. IVF treatment cost in India gives hope to childless couples who want to experience the joy of becoming parents. Many people suffer from anxiety and depression because of severe infertility problems. Many couples cannot conceive a baby and hence cannot become parents. Many couples lives are destroyed because of infertility issues. These couples are forced to live childless lives or adoption is the last option. IVF (in vitro fertilization) is the best method with higher pregnancy chances. Many centres provide affordable fertility treatments in India than in other developed or developing nations like the USA and UK, etc. India offers budget IVF options with a higher success rate than in many other countries. Many low-cost IVF clinics offer ART (assisted reproductive technology) methods that have a high success rate in conceiving a healthy baby. The latest technologies with advanced equipment are used in the best IVF clinics for successful treatments. The cost of IVF treatment depends on several major factors such as the clinic's reputation, fertility doctor's experience, medical staff qualification, etc. Low-cost IVF clinics in cities like Delhi offer qualified staff with good communication skills in English and specialists with medical degrees from the UK and USA. India offers IVF treatment at World Fertility Services between INR 1,50,000 and INR 3,00,000. This cost of IVF treatment covers health checkups, fertility medications, several tests and examinations, retrieval of the intended parent`s gametes, fertilization process, and implantation. Many advanced procedures like ICSI, IMSI, TESA, PESA, FET, PICSI, and sperm or egg donation will also increase the cost of IVF treatment in India. What are the factors affecting IVF costs in India? There are many factors affecting the IVF cost in India. If the female partner is suffering from irregular ovulation such as PCOS or PCOD, irregular menstrual cycles, extended or no periods, and endometriosis, she will need advanced IVF treatments. If a female partner has blocked, broken, or no fallopian tubes, the chances of conception are poor. Previous failures in ART methods or IVF cycles will also affect the cost of IVF procedures in India. Whereas in a male partner, poor quantity or quality of sperm will also affect the cost of the IVF procedure. The age is very important as the quantity or quality of the gametes of the couple decreases as they become older. If the couple needs donor or sperm assistance, the rate of success of conception will increase. The fertility doctors who have advanced skills and knowledge will also increase the overall budget of the IVF treatment. The reputation of the hospital in India will also increase the budget of IVF treatment for the intended parents as these hospitals only focus on satisfaction.

What are the steps involved in IVF treatment in India?

There are many steps involved in IVF treatment in India including health check-ups of the intended parents. These tests and examinations also help to know the quality and the quantity of the couple`s gametes. The fertility doctor will do blood and ultrasound tests to know the genetic or hereditary disease of the couple. These tests help in preventing the transmission of any genetic or hereditary disease of the couple to their newborn baby. The expert will also suggest certain drug medications to boost the quantity and quality of eggs. These medications will stimulate the ovaries to produce mature eggs in the female ovaries. The experts will retrieve these mature eggs from the uterus of the intended parents. These mature eggs will be collected with the help of a device named a catheter and a fine needle. During the same time, the expert will ask the male partner to provide a sample of the semen. The expert will prepare the sample by cleaning and eliminating any undesirable particles. The specialist will place the female eggs and male sperm on a petri dish to combine them. The doctor will monitor the growth of the fertilization for a few days to form an embryo. These embryos will be monitored for a few days inside a laboratory by the doctor. The high-quality embryos will be chosen for the implantation process. The expert will implant the embryos inside the uterus of the intended female parent with the help of a catheter and a fine needle. The embryos will be attached to the wall of the uterus. After two weeks, the expert will do blood and ultrasound tests to confirm the pregnancy. After nine months, the female partner will deliver a healthy biological baby either with a C-section or normal vaginal delivery.

Read More:- https://worldfertilityservices.com/blog/ivf-blog/how-much-does-ivf-cost-in-india/

[firasezz]

Buy feel great system , click the link below or click on my picture then...

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The Feel Great System is a nutritional system with two scientifically designed food products. They help with cravings, hunger, fatigue, crashes after meals, bloating and supporting healthy blood sugar and cholesterol levels.

The Feel Great System was created by Rav Malik because he saw a big need for the average person who is struggling to maintain a healthy lifestyle without shakes, cutting out carbs. or doing an extreme diet.

Medical Disclaimer

THIS VIDEO IS NOT DESIGNED TO, AND DOES NOT, PROVIDE MEDICAL ADVICE. ALL CONTENT (“CONTENT”), INCLUDING TEXT, GRAPHICS, IMAGES AND INFORMATION IN THIS VICEO ARE FOR GENERAL INFORMATIONAL PURPOSES ONLY.

THE CONTENT IS NOT INTENDED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS OR TREATMENT. NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE, OR DELAY IN SEEKING IT, BECAUSE OF SOMETHING YOU HAVE SEEN IN THIS VIDEO. NEVER RELY ON INFORMATION FROM THIS VIDEO IN PLACE OF SEEKING PROFESSIONAL MEDICAL ADVICE.

THE OWNER OF THIS VIDEO IS NOT RESPONSIBLE OR LIABLE FOR ANY ADVICE, COURSE OF TREATMENT, DIAGNOSIS OR ANY OTHER INFORMATION. YOU ARE ENCOURAGED TO CONFER WITH YOUR DOCTOR WITH REGARD TO INFORMATION CONTAINED.

#feelgreatsystem #feelgreat #fee_great #feel_great_system

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[peny-thakur]

Famous Endocrinologist in Lucknow-Dr. Mayank Somani

Dr. Mayank Somani: A Renowned Name in Endocrinology for Lucknow and Beyond

In the bustling city of Lucknow, where healthcare flourishes, there are names that stand out for their expertise and dedication. Among these, Dr. Mayank Somani has carved a niche as a famous endocrinologist in Lucknow. His exceptional qualifications, vast experience, and patient-centric approach have made him a sought-after doctor for all things related to hormones.

A Stellar Academic Background and Global Exposure

Dr. Somani's journey to becoming a renowned endocrinologist began with a solid foundation. He graduated with MBBS from the prestigious King George's Medical University (KGMU), Lucknow, itself a testament to his academic brilliance. He further distinguished himself by bagging a Gold Medal in MD (Medicine). But Dr. Somani's ambition didn't stop there. He broadened his horizons by pursuing MRCP certifications from the Royal College of Physicians, UK, in Acute Medicine, Diabetes & Endocrinology, and FCCP (Critical Care) from the USA. This international exposure equipped him with the latest advancements and best practices in endocrinology.

Unparalleled Expertise in Treating Hormonal Imbalances

Endocrinology is a complex field dealing with the intricate network of hormones that regulate our bodies. Dr. Somani's expertise encompasses a wide range of hormonal issues, including:

Diabetes:

 A leading famous endocrinologist in Lucknow for diabetes management, Dr. Somani helps patients achieve optimal blood sugar control through personalized treatment plans.

Thyroid Disorders:

 From hyperthyroidism to hypothyroidism, Dr. Somani uses his vast knowledge to diagnose and treat thyroid conditions effectively.

Pituitary Disorders:

 Pituitary gland dysfunction can disrupt various bodily functions. Dr. Somani's expertise extends to accurate diagnosis and management of these delicate conditions.

Adrenal Disorders:

 Adrenal gland issues can cause a cascade of symptoms. Dr. Somani's experience allows him to effectively diagnose and manage these complexities.

PCOS (Polycystic Ovary Syndrome):

 This hormonal imbalance in women can lead to various problems. Dr. Somani's approach helps manage PCOS symptoms and improve overall well-being.

A Patient-First Philosophy Sets Him Apart

Dr. Somani's success transcends his qualifications and experience. He is renowned for his patient-centric approach. He listens attentively to each patient's concerns, thoroughly investigates their condition, and involves them in the decision-making process. This collaborative approach fosters trust and empowers patients to actively participate in their health journey.

Technology Meets Expertise: A Modern Approach to Care

Dr. Somani embraces advancements in medical technology. He integrates diagnostic tools and treatment protocols seamlessly into his practice, ensuring patients receive the most up-to-date care. This blend of expertise and modern medicine sets him apart as a famous endocrinologist in Lucknow.

Seeking Consultation with Dr. Mayank Somani?

If you're seeking a highly qualified and compassionate endocrinologist in Lucknow, Dr. Mayank Somani is an excellent choice. His dedication to patient well-being, combined with his vast experience and cutting-edge approach, positions him as a leader in the field of endocrinology. Schedule a consultation with Dr. Somani and take control of your hormonal health today.

Address: Apollomedics Hospital, Kanpur - Lucknow Rd, Sector B, Bargawan, LDA Colony, Lucknow, Uttar Pradesh 226012

Phone: 084290 25275

Direction: Visit

Products and services: instagram.com

Opening Hours: ( Monday to Saturday )-11:am-3pm

[of-another-broken-heart]

Fun quick update.

I am just about out of my PCOS medication.

I left a message on Monday requesting a prescription refill from my gyno, complete with exhausted chronically ill incurably diseased salty reminder that there is an ongoing mass-killing mass-disabling pandemic and that I really don’t want to die to it.

I got a voicemail today from someone there, claiming I needed to call back.

So I forced myself to make more calls today.

Four hours. Five calls.

First, my gyno office. To find out what was up with the voicemail.

Well, it turns out, they don’t care that there’s an ongoing pandemic and that I’m immunocompromised. Or that I have no transportation—not that we got to the point where transportation was a consideration, mind you. No no. You see, this office is masks-off, now. Anti-science, now. Pro-plague, now. A pool of piss—but oh, don’t worry! If it makes you FEEL better, you are still allowed to mask!

No. You keep your fucked up death kink away from me.

So, second call. (And third, and fourth). To my PCP’s office. My former PCP’s office, as it turns out. I ask if my doctor still works out of this office. Yes. I ask if they are still offering telehealth. “Let me check.” I’m put on hold. I wait. “Okay, so when do you want to come in for an appointment?” No. I asked for telehealth. This office, there is thorough documentation of my difficulty (impossibility) of getting to in-person appointments. “Well, since we haven’t seen you in-person in three years, there’s nothing we can do. Call back when you FEEL we can help you.” This took three calls because the nurse I got handed off to, twice, hung up on me. “You’re still free to mask if it makes you FEEL better!” I ask what the difference in effectiveness is, between one-way masking and universal masking. “I’m not going to argue with you.”

I didn’t even get to speak with my doctor. She was too busy. Guess I can call her a plague doctor now, since she chooses to work in an anti-science “DO harm” office full of staff who are demonically eager to spread their infections to their ill charges. And are probably rallying for USA to adopt MAID.

Health”care” workers who scoff at health data and science, and who literally do not care.

I had a real fucking bad time.

I cried a lot.

I wrote a 4-page letter to my doctor. I folded it as if I’d mail it. I considered it. A doctor break-up letter, detailing the disrespect, the dismissal, the lack of sympathy, the gaslighting of being told that if I FEEL safe, then I shouldn’t have any problem. The problem is that I don’t FEEL the correct way. It’s definitely not because they elected to completely violate their oaths, noooo. It’s also not because they fucking lied to me.

I left the letter on the dining table. So maybe my mom would see it and read it (she did, and started to). So maybe I would get an envelope and stamp (probably won’t happen).

And my final call was to Planned Parenthood. Because when health”care” chooses plague-negligence instead, you can count on a highly-contested staple of affordable, accessible care to maintain a standard.

And they do. They still mask. They still offer telehealth.

I have a virtual appointment on Monday. And I’ll be figuring out when to go for an in-person, universally masked visit for my (several years overdue) annuals.

Health”care” is a fucking sham. Health”care” workers are lying selfish money-obsessed death freaks. And Planned Parent hood is, as always, an all-star.

[pcosdiva123]

How Long Will It Take Me to Get Pregnant If I Have PCOS?

Polycystic ovary syndrome (PCOS) is a common condition affecting many women of reproductive age. One of the significant concerns for those with PCOS is fertility. Understanding how long it might take to conceive with PCOS can be complex, as it varies from person to person.

PCOS often causes irregular menstrual cycles and an imbalance in hormones, which can disrupt ovulation. This irregular ovulation is a primary reason why getting pregnant can be challenging. Women with PCOS might not ovulate every month, making it harder to predict when they are most fertile.

However, having PCOS doesn’t mean pregnancy is impossible. Many women with PCOS conceive with or without medical intervention. The time it takes to get pregnant can depend on several factors, including the severity of PCOS symptoms, age, lifestyle, and overall health.

For some women, making lifestyle changes such as maintaining a healthy weight, eating a balanced diet, and exercising regularly can help regulate menstrual cycles and improve fertility. Weight management can be particularly beneficial, as even a modest reduction in weight can sometimes restore ovulation and increase the chances of conception.

Medical treatments are also available to help manage PCOS and improve fertility. Medications like Clomid (clomiphene citrate) can stimulate ovulation, and other drugs like metformin can help manage insulin levels and support ovulation. In some cases, more advanced treatments such as intrauterine insemination (IUI) or in vitro fertilization (IVF) might be considered.

The time to conceive with PCOS can also depend on how well these treatments are tailored to individual needs. While some women with PCOS may become pregnant within a few months of trying, others might take longer. On average, it can take up to a year for women with PCOS to conceive, but this varies widely.

If you’ve been trying to conceive for over a year without success, it’s advisable to consult a fertility specialist. They can provide personalized advice and treatment options based on your specific situation.

Ultimately, patience and persistence are key. Many women with PCOS do achieve pregnancy, and advancements in treatment continue to improve the chances of conception. It’s essential to stay informed and work closely with your healthcare provider to navigate your journey to parenthood.

[drsunitha]

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• Member European Academy of Dermatology & Venerology (EADV), Switzerland

• Member International Society of Dermatology (ISD) (USA)

• Member International Society of Pediatric Dermatology (ISPD), Madrid, Spain

• Life Member Association of Facial Aestheticians & Aesthetic Surgeons of India (AFAASI)

• Life Member Pigmentary Disorders Society (PDS)

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[philipkindreddickhead]

I often seen critiques of make up from an existential/philosophical perspective, but I rarely see criticism of cosmetics from a stand point of the very physical bodily harm it does. I think this is because the number of dangerous ingredients is so massive, and overlapping its an absolutely daunting task. So I've compiled the information I've found and bear with me its a lot. (This is from an American perspective. Sorry, thats what I know. However I would love it if people from other countries had things to add.)

First I want to get the "simple" stuff out of the way. I think almost everyone has heard about bacteria and fungi in makeup and that makeup causes acne from clogging pores. Makeup has a pretty strict shelf life, yet consumers are entirely supposed to self-police as Ive never seen a single expiration date on any cosmetic packaging. (I guess consumers are meant to pull this knowledge out of the ether or something. I only found out about it in a tumblr PSA. I did read that expirys are on products in Europe.) Beauty blenders are the worst offender because theyre almost always moist. When I was taught makeup I was told to wet my sponge so it would soak up less product. If you apply makeup daily your sponge is likely constantly damp. USA Today had an article which said that 96% of sponges had fungi and over 60% had E. Coli in them. But I think what people talk about less is the complication of problems from using other products in conjunction with dirty beauty blenders. USA Today warns its especially dangerous to use beauty blenders if you have damage to your skin like acne, cuts, or dry skin. However the most popular beauty products for washing your face contain walnut pieces for literally scrubbing your skin and creating microabrasions. If youre a frequent makeup user you probably know about the cyclical nature of applying foundation, breaking out, and then applying more foundation to cover the breakout. You may even be using scrubbing cleansers more frequently to combat the acne creating more tears. This can lead to "blood poisoning" and, though neither USA today or Forbes mentions this, blood poisoning (not a medical term btw. Its sepsis.) according to numerous medical sites has the potential to be extremely lethal. The symptoms are so similar to a regular flu its nearly impossible to self-diagnose.

The very first thing I was told when a friend handed me a jar of finishing powder- popular with many beauty gurus for the "baking" technique and considered a must have- was a joke about "clown lung." This was a reference to the main ingredient talc. Talc causes lung problems including cancer and respiratory illness. If anyone remembers the large Johnson and Johnson lawsuit from 2019 it was because theyd been putting talc into baby powder. Talc is dangerous because it's impossible to mine and seperate from ASBESTOS. Some high-end finishing powders will try to sell you on safe talc-free formulas but all the products I looked into contained mica instead which causes pneumoconiosis, colloquially known as "black lung disease." Like fucking coal miners get. Its not just present in finishing powder either. In my research it turned out that talc/asbestos are also present in many eyeshadows and other powder products. [Googleable, evidenced in J&J lawsuit]

Another industry to examine is nail salons. Toluene, Formaldehyde, Dibutyl Phthalate, and Methacrylate compounds are all dangerous ingredients and present in various salon products. These ingredients cause a range of problems from dizziness, drowsiness, birth defects, slow fetal growth, future intellectual disabilities in the fetus, eye skin and throat irritation, coughing, allergic reactions, asthma-like attacks, short-term memory loss, nausea, dermatitis, cancer, and misscarriage. Some nail products advertise that they are 3-free meaning that toluene, formaldehyde, and DP should be absent but often the labels are found to be completely inaccurate. It should be noted that the risk is mainly to salon workers and not patrons but ask yourself if it is right to place other people at serious risk for your aesthetic. OSHA does make an attempt to mitigate these risks however not once in my years of makeup queen did I see a salon following these directives which include constant air monitoring, half mask respirators with chemical cartridges, gloves, long sleeves, and safety glasses. (And Im not even going to touch issues of human trafficking/slave labour out of nail salons one case of which occured 5 days ago two hours away from me) It should also be noted that formaldehyde can also be found in hair relaxers and hair dyes. [Found articles in Scientific American and NYT]

I also found on the FDAs website that many cosmetics include heavy metals like arsenic, mercury, and lead. (Usually accompainied by a picture of lipstick so I assume that is the product most likely to contain it, however campaign for safe cosmetics lists foundation as containing heavy metals, and The Guardian has an article about skin lighteners from Asia and Africa containing mercury.) The website stated that the amount of these heavy metals in cosmetics is "safe" if used as intended. (and I'm going to come back to the concept of "intended use" later because thats a can of worms too) However, when searching for info on heavy metal safety I found this quote in regards to metals in food:

"Certain metals, such as arsenic, lead and mercury, have no established health benefit, and have been shown to lead to illness, impairment, and in high doses, death. Understanding the risk that harmful metals pose in our food supply is complicated by the fact that no single food source accounts for most people’s exposure to metals in foods. People’s exposure comes from many different foods containing these metals. Combining all of the foods we eat, even low levels of harmful metals from individual food sources, can sometimes add up to a level of concern"

So like, which is it? Is it a "safe amount" or is no amount of metal safe? I understand that in the case of certain foods like fish some amount of mercury poisoning is always expected but fish is also something you feed yourself and nourish your body with while cosmetics are completely unecessary to your survival. The mercury problem in fish is also mitigated by health warnings when mercury levels are particularly high but cosmetics have no such warning. Another warning on the site indicated that children should ingest NO amount of lead AT ALL because it is particularly harmful for kids yet theres no effort to stop children from using lead-containing cosmetics. I worked next to a Five Below where I was shocked to find they sold Jeffree Star and Anastasia eyeshadow dupes for five dollars which amounts to fucking pocket change for a lot of kids and kids do buy that stuff. I also think its ironic the FDA would have anything to say regarding cosmetics because in the very same article about heavy metals in cosmetics the FDA says that they DO NOT REGULATE cosmetics beyond the color additives.

Mascara, eyeliner, lipstick, and brow tint often contain carbon black. This is a color additive that is an incomplete combustion of carbon-based products. It can cause lung disease, cancer, and organ system toxicity, and eye, nose, throat irritation. The effects are mainly studied in rats and those at biggest risk are industrial workers but why do other workers have to endure lung problems for something so unecessary? [Easily googleable, NIH, CDC, WHO Europe]

This next bit I only want to mention briefly because I didnt find any particularly reputable sources about it, but its a claim that cropped up repeatedly and I think its an interesting one. Parabens, estrogen, phthalates (again), and pesticides in cosmetics are apparently linked to endocrine disorders and hormone dysregulation. Im not entirely sure what is meant by this accusation. Endocrine disorders include female diseases like PCOS and possibly endometriosis. None of these diseases is very well studied and the female endocrine system itself is not well studied either. Im not saying "cosmetics cause PCOS" because we dont know if PCOS or these other endocrine/hormonal disorders are genetic or environmental or both (it appears that PCOS is largely genetic and Endometriosis is likely autoimmune related) AND we dont appear to know for sure that cosmetic ingredients cause endocrine disorder. But I include anyway for a number of reasons:

If you happen to struggle with hormonal problems you may want to know cosmetics is a potential environment factor.

These conditions are incredibly painful. It will be a battle getting your doctor to even acknowledge that pain for diagnosis. PCOS is linked to diabetes, and heart disease. [Thanks @mother-of-pearl ] There is no cure and the treatments are often throwing hormonal birth control at it and hoping for the best.

I dont anticipate the link between cosmetics and endocrine disorders being studied any time soon or any endocrine disorders studied at all because the medical/scientific field is sexist. I dont want women to suffer in the mean time.

Now again, take this with a grain of salt because I couldnt find scientific or news sources for it. Dont fucking come for me. Im not gonna respond to you. [Most reputable source was a paper from the library of medicine at the national institutes of health but it was behind a paywall and I dont have 39 dollars to be right on tumblrdotcom]

Avoiding these ingredients is not as simple as scanning the label for them. As many beautubers and the community are no doubt aware considering multiple scandals over veganism. Products advertised as vegan or cruelty free but contain non-vegan carmine or are sold in China which legally requires the products to be animal tested. Cosmetic companies will hide ingredients claiming they are "trade secrets" or they will be placed under "fragrance." Many ingredients will be known by six or seven different names and asking consumers to be aware of seven different names for multiple ingredients requires consumers to be aware of innumerable different, often complicated ingredient names. I shouldnt have to point out that's a ridiculous burden to place on women. The EU banned 1,300 hazardous ingredients that the US did not. Cosmetic companies rely on women being unwilling/unable to bring in a list of 1,300 ingredients- with multiple names- every time they pop in to the drug store, sephora, or wherever. Buying "natural" products will not help you either. Theres no established criteria for natural/organic in costmetics, the FDA doesnt test these products, and "natural"=/= safe anyway. Plenty of plants and minerals are poisonous. One good example is traditional kohl products which advertise their natural status but also naturally contain lead and reiterating that natural powders contain mica. US courts are rarely on the side of consumers either. I found an interesting lawsuit against St. Ives for their apricot scrub taken to court for their "dermatologist tested" label despite it causing breakouts and cuts to the skin. The courts ruled that this label was fine because it only indicated that the product was TESTED not APPROVED by dermatologists. However I think any rational consumer would look at this label and assume the tests concluded it was safe for use or else why put the label on there?

[Googlable XMONDO drama, googlable laws wrt china and eu, already stated about FDA, FDA website about Kohl. Googled St. Ives lawsuit.]

I want to return to the idea of "intended use." This is sort of a fucky concept a lot of companies have ways of getting around. My "last straw" with makeup had to do with a run-in I had with Anastasia over their "Riviera" eyeshadow palette. In this pallette they had two colors that were the real feature of the palette, an electric neon purple and a radioactive pink I mean every photo, every promotion has these two colors swirled together around the eye. Because again, its an eyeshadow palette. When I buy the eyeshadow palette of course there's a little insert warning in the package that says these two shades are not intended on the eye area. In an eyeshadow palette. Contacting their customer service they told me that these two shades were meant to be used as a blush. neon purple blush. Not only that, but their website and instagram featured NO models wearing the shades as blush while EVERY model one or more of the shades as eyeshadow. When asked about this discrepancy ABH stopped responding. What I find egregious about this is the amount of people who dont know, and then more staggeringly; dont care. The sephora clerks didnt know, the in store abh representative didnt know, their customers didnt know, and when I told them they would respond with "oh, [brand] did the same thing with their [shade]." Sure enough, when I demanded that store clerks open the packaging to look for warnings nearly every product had an "eyeshadow" that was not intended for use on the eyes. Relegating dark, red-toned teal to "contour" and neon grean to "highlighter" US-based cosmetic junkies will say that these pigments have been approved for use by the EU however I found absolutely NO evidence of that. I googled it a thousand ways but all I ever found were blog posts, reddit comments, and one quote from an apparently nonEuropean layman in an Insider article. I even changed my location to France on ABH's website and the Norvina palette still contains the same warnings (not to harp on ABH in particular. I just know which shades in particular are the problem there). The Insider article noted that brands who were selling pressed pigments declined to comment. If the pressed pigments were EU friendly, I would think companies would be clamouring to say so. It also still makes their market as eyeshadow colors illegal in the US. (If any Europeans would like to chime in I'd love that.) Another problem I find with cosmetics companies and their reps is the claim that the worst thing that could happen is eye irritation for those with sensitive eyes and staining. How could they possibly know? The FDA doesnt test, or approve these cosmetics in the eye area, so ostensibly no one should be using it that way.

The next one is a bit of a "duh" but I'm going to talk about it anyway. Counterfeit cosmetics are a booming market full of untold dangers. Untold primarily because these products could contain literally anything. Ive read about glue, arsenic, lead, feces, staph, and horse urine to name a few. The labels and ingredient list on these products are fake. Legitimate brands often unintentionally play into the counterfeit market. They create artificial scarcity by making less of the product than is actually needed for consumer demand to create an even higher demand. If consumers miss out often their only chance at getting the product is to turn to counterfeits. I found examples of women who had their lips superglued, lips "turned to goo" and burned to blistering, throat closures, women with stys, contact dermatitis, eye infections. I think we as a society turn a blind eye to this problem because we think "hey, if youre buying counterfeits for a discount and you get hurt you deserve it." We imagine idiots buying products for 4 dollars from ebay or perusing Canal street for FEИTY beauty. But these counterfeits can be really convincing. I myself received a gift of a huda palette that I only recognized something was weird about it because I'd swatched it at sephora about five times earlier that month. The person who bought it for me actually paid MORE than the usual cost for the palette because it was advertised as a newer, better edition. The websites can be disturbingly similar. For instance Kylie Jenner's legitimate website is KylieCosmetics.com but you can find fakes at kyliecosmeticsshop.co.uk. These fakes can buy ad space and be one of the first sites that populate when you google the products instead of typing the legitimate site into the address bar. Counterfeits can also be bought and sold through third parties on websites like ebay, wish, and amazon. (My gift actually came from Amazon.)

[Netflix doc "Broken" ep "Makeup Mayhem" Corroborated by personal experience and google]

[apollodrome]

1- the logical thinking indicates that the most probably option is usually the correct option, for example, if a man has lung cancer the most likely option is that is lung cancer is related to his tabaquism, the same aplly on this case, if a person with morbid obesity has some kind of circulation problem then the most likely option is that is related to the weight of that person, now about your question, if you wanna know how morbid obesity relates to health problems then my answer is

2 - read a goddanm biology book (or just google it), the answer is right there, you dont need to ask a random person on the internet about that, and guess what, you cannot put links into asks so im unable to give you the link to any kind of article explaining that, if you wanna know the corelation then just search morbid obesity on wikipedia.

---

This ask is about this post where a woman's health issues are blamed by doctors on her weight, so she loses the weight, and when doctors see that her health issues have not gotten better, but have gotten worse, they order tests that they should have ordered months ago.

I think you misunderstand the point of the post. Let's take the obesity out of this. A woman goes to the doctor for severe cramps, sleepiness during the day, memory and balance problems. Doctors refuse to treat her. That's all there is to this issue - a woman has gone to a medical professional with a set of symptoms, and the medical professional did not test her for the conditions that have the above symptoms.

You give me an example in your ask of smokers having an increased risk of lung cancer, so let's apply this analogy here. A smoker goes to the doctor and says, "doctor, I have difficulty breathing, a painful cough that doesn't go away for months, I lost 50 pounds in less than a month, pain in my hands, fingers and chest." These are very common symptoms of lung cancer. So, what you're advocating for, is that the doctor should refuse to order any tests for the patient, tell them to stop smoking, and send them on their way. We know that some health risks are associated with obesity, in the same way that lung cancer is associated with smoking, so should we not be testing those people for those diseases more often?

People whose father has died of heart disease are at more risk of heart disease, so we test those people for heart disease when they mention they have symptoms. People whose family has ADHD are more at risk of having ADHD, so we test those people for ADHD when they mention they have symptoms. Why is obesity any different? If a disease has already developed, losing weight will do nothing except for decrease that initial risk, but it's past that already if they HAVE THE DISEASE. They have to be treated for the disease. Thin people can get heart attacks, and non smokers can get lung cancer or develop asthma, so why do those people go to the doctor with those symptoms and get tested, and obese people don't?

In some of your replies on that post, you have used this Wikipedia page as your source. On the same page, it says,

"While a majority of obese individuals at any given time are attempting to lose weight and often successful, research shows that maintaining that weight loss over the long term proves to be rare." (Wikipedia includes a reference for this, I've linked it here).

I am using the same research you are using to argue my point. If an obese individual walks into a doctor's office with symptoms of a heart condition, and is told to lose weight, they are basically sentenced to death. As we can see above, long term weight loss may lead to more health risks, and is actually very rare in most people (less than 1 in 100 obese people manage to lose the weight and stay at the new weight), and so if a doctor tells an obese person not to come back until she has lost all of the weight, she may actually die before she comes back to the doctor.

Obesity is an issue, and does increase the risks of some conditions. However, according to the same Wikipedia article you and I have both been using,

"obesity has individual, socioeconomic, and environmental causes, including diet, physical activity, automation, urbanization, genetic susceptibility, medications, mental disorders, economic policies, endocrine disorders, and exposure to endocrine-disrupting chemicals."

I don't want to assume you're enough of a heartless monster to say "obese people brought this on themselves and therefore deserve to suffer and die due to medical malpractice" as a response to my above point, but JUST IN CASE YOU WERE, that's a whole lot of people you're condemning. You're condemning children who grow up in poverty and whose parents can only afford McDonald's (cheaper than vegetables in the USA), you're condemning my uncle, who had a deadly thyroid issue that wasn't treated in time (he grew up in Soviet Russia) and messed up his metabolism so bad he currently exercises for 3 hours a day but is still extremely overweight. You're condemning people with pcos, people with hyperthyroidism, people with eating disorders and depression. All of those people, in your opinion, do not deserve medical treatment.

With what we now know, let's summarise.

Fact 1: people who are obese have a higher risk of developing certain disorders, in the same way that someone with a family history of heart problems may develop heart problems, however, no disease is directly CAUSED by obesity and obesity alone. If that were the case, thin people wouldn't get those diseases at all, but I know many thin people with narcolepsy, cancers, and heart issues.

Fact 2: obesity can be caused by many factors, not just eating a lot of junk food. I've already mentioned hyperthyroidism, eating disorders, pcos, and poverty as some of those factors, but there are more. A lot of those factors are not the fault of the obese individual. We also know that once someone is already obese, keeping off weight that they lose is extremely difficult and takes a long time.

Fact 3: when a smoker goes to the doctor with symptoms of lung cancer, they are told to stop smoking, but they are also SCREENED FOR LUNG CANCER and TREATED IF THERE IS LUNG CANCER PRESENT.

Fact 4: according to the woman in the original post, she went to the doctor with symptoms of narcolepsy and other issues, was told to lose weight, BUT WAS NOT TESTED FOR THE DISEASES SHE IS AT RISK FOR, OR TREATED.

Do you see my point now? Yes, obesity is linked to diseases, but that should mean that people who are obese are screened and treated MORE OFTEN, not less or god forbid not treated at all. Preventing obesity by exercising and eating well is something we should definitely do ON A GLOBAL SCALE (better mental health help for people with depression/eating disorders, cheaper vegetables for people in poverty, more education, less fast food places), to decrease our risk of the diseases that obesity is associated with increasing the risk for (type two diabetes, sleep apnea, narcolepsy, certain cancers), but if someone is already obese, weight loss is no longer a cure, and actual treatment needs to be administered. Weight loss was never a cure, it is a PREVENTATIVE MEASURE, and not even a good one according to the evidence I've provided above. Healthy eating and exercise are good preventative measures, but they do not always contribute to weight loss. So why do doctors prescribe weight loss in the form of pills and calorie restriction, rather than eating HEALTHY and exercising? ALSO, if weight loss was a cure, non-obese cancer patients, non-obese people with narcolepsy, and non-obese people with eating disorders would also be told to lose weight rather than given treatment. So why is weight loss the ONLY treatment doctors give obese people? Obesity is much more complicated than a person just eating a lot of junk and getting fat, that's not how it works.

You know how we "eliminate the most probable option"? WE TEST THE PATIENT FOR IT, AND IF THE TEST COMES BACK NEGATIVE WE ELIMINATE THE OPTION. Why was the woman in the post not tested, and why do you advocate for this? Why do you think a group of people deserves medical attention less than others?

Here's another analogy. Wearing a mask and staying six feet away from others is a PREVENTATIVE MEASURE for covid. When a person already has covid, they are not told to wear a mask and stay six feet away from others. They are put in a hospital and treated. What you are advocating for is akin to sending a person with covid symptoms away with a mask, and not treating them at all.

To summarise: correlation is not causation, all people deserve medical help (people who are turned away from doctors a LOT are women, people of colour, and fat people. Medical discrimination needs to be eradicated in all of those cases) and you are in no position to decide who deserves to be treated and who doesn't.

I'm not overweight myself. I just care about people receiving the medical treatment they need and deserve, regardless of what they look like or what other conditions they already may have. I recommend really looking at yourself and examining the biases you have against fat folks, and figuring out how to become better as a person. You seem to enjoy giving unsolicited medical advice, so here's some from me: stop being a dick.

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