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I think spinal fusion has a better success rate than the rod & pins I was offered and I denied. I've done better on my own than any of the Dr's I've seen over the past 2 years. Any of the pain meds prescribed didn't touch it, including Oxycodone.
My back is fucked and it sucks. I used to be a scratch golfer and had to quit playing. I used to get REALLY strong meds but now with the new laws and all the people that abuse drugs I only get 7.5's, 800 mg Gabapentin, Ibuprofen, and Tizanadine. the Tizanadine probably helps the most, especially in helping go to sleep at night... but when I wake up every morning I feel like I've been kicked in the back by a mule.
I think spinal fusion has a better success rate than the rod & pins I was offered and I denied. I've done better on my own than any of the Dr's I've seen over the past 2 years. Any of the pain meds prescribed didn't touch it, including Oxycodone.
Spinal fusion involves rods/pins and plates along with the spacer that encourages bone growth.
You have to have something to hold it all together while the vertebrates grow together..or fuse.
What did they use between your vertebrae? The first doctor I saw a long time ago, who was an orthopedic surgeon, said they would harvest bone from my pelvis. Of course that was all the way back in 2004.
I think spinal fusion has a better success rate than the rod & pins I was offered and I denied. I've done better on my own than any of the Dr's I've seen over the past 2 years. Any of the pain meds prescribed didn't touch it, including Oxycodone.
My back is fucked and it sucks. I used to be a scratch golfer and had to quit playing. I used to get REALLY strong meds but now with the new laws and all the people that abuse drugs I only get 7.5's, 800 mg Gabapentin, Ibuprofen, and Tizanadine. the Tizanadine probably helps the most, especially in helping go to sleep at night... but when I wake up every morning I feel like I've been kicked in the back by a mule.
I think spinal fusion has a better success rate than the rod & pins I was offered and I denied. I've done better on my own than any of the Dr's I've seen over the past 2 years. Any of the pain meds prescribed didn't touch it, including Oxycodone.
My back is fucked and it sucks. I used to be a scratch golfer and had to quit playing. I used to get REALLY strong meds but now with the new laws and all the people that abuse drugs I only get 7.5's, 800 mg Gabapentin, Ibuprofen, and Tizanadine. the Tizanadine probably helps the most, especially in helping go to sleep at night... but when I wake up every morning I feel like I've been kicked in the back by a mule.
They gave me 100 NORCO after the surgery and another 40 after seeing the surgeon a few weeks later.
They did a good job of keeping the pain manageable.
While the recovery has been harder than my cancer surgery and my hip replacement combined I'd do it again.
I think spinal fusion has a better success rate than the rod & pins I was offered and I denied. I've done better on my own than any of the Dr's I've seen over the past 2 years. Any of the pain meds prescribed didn't touch it, including Oxycodone.
My back is fucked and it sucks. I used to be a scratch golfer and had to quit playing. I used to get REALLY strong meds but now with the new laws and all the people that abuse drugs I only get 7.5's, 800 mg Gabapentin, Ibuprofen, and Tizanadine. the Tizanadine probably helps the most, especially in helping go to sleep at night... but when I wake up every morning I feel like I've been kicked in the back by a mule.
yeah, mine is too. L2 thru S1. Arthritis & Degeneration causing a slight curve and nerve roots, amongst other things. I have been given Oxycodone, Tramadol, Diclofenac?, Toradol injections and several others. The only things that did work were the Toradol injections......if the right nurse gave it in the right spot. Sometimes it helped & other times it didn't. Is supposed to work for 24-36 hours but usually lasted between 10-12 hours.
Also plain old fashioned aspirin......but taking 2 at a time, 4-6 times a day was putting my liver at risk and thinned my blood to water, so I alternated it with Tylenol. That is until I got hives several times and I quit the aspirin all together and trying a more natural approach. It's been a slow and painful process and I still have pain, and some days are better than others, but I haven't taken anything since November.
Thing is, my pain isn't so much in my back itself as it is in the hip area and down the left leg and it changes often (location, type & degree of pain, muscles/nerves, etc) so this leads me to believe there is more going on than just my back.........but several Dr's, including an Orthopedist & a Neurologist say otherwise.
I think spinal fusion has a better success rate than the rod & pins I was offered and I denied. I've done better on my own than any of the Dr's I've seen over the past 2 years. Any of the pain meds prescribed didn't touch it, including Oxycodone.
My back is fucked and it sucks. I used to be a scratch golfer and had to quit playing. I used to get REALLY strong meds but now with the new laws and all the people that abuse drugs I only get 7.5's, 800 mg Gabapentin, Ibuprofen, and Tizanadine. the Tizanadine probably helps the most, especially in helping go to sleep at night... but when I wake up every morning I feel like I've been kicked in the back by a mule.
yeah, mine is too. L2 thru S1. Arthritis & Degeneration causing a slight curve and nerve roots, amongst other things. I have been given Oxycodone, Tramadol, Diclofenac?, Toradol injections and several others. The only things that did work were the Toradol injections......if the right nurse gave it in the right spot. Sometimes it helped & other times it didn't. Is supposed to work for 24-36 hours but usually lasted between 10-12 hours.
Also plain old fashioned aspirin......but taking 2 at a time, 4-6 times a day was putting my liver at risk and thinned my blood to water, so I alternated it with Tylenol. That is until I got hives several times and I quit the aspirin all together and trying a more natural approach. It's been a slow and painful process and I still have pain, and some days are better than others, but I haven't taken anything since November.
Thing is, my pain isn't so much in my back itself as it is in the hip area and down the left leg and it changes often (location, type & degree of pain, muscles/nerves, etc) so this leads me to believe there is more going on than just my back.........but several Dr's, including an Orthopedist & a Neurologist say otherwise.
I think spinal fusion has a better success rate than the rod & pins I was offered and I denied. I've done better on my own than any of the Dr's I've seen over the past 2 years. Any of the pain meds prescribed didn't touch it, including Oxycodone.
My back is fucked and it sucks. I used to be a scratch golfer and had to quit playing. I used to get REALLY strong meds but now with the new laws and all the people that abuse drugs I only get 7.5's, 800 mg Gabapentin, Ibuprofen, and Tizanadine. the Tizanadine probably helps the most, especially in helping go to sleep at night... but when I wake up every morning I feel like I've been kicked in the back by a mule.
They gave me 100 NORCO after the surgery and another 40 after seeing the surgeon a few weeks later.
They did a good job of keeping the pain manageable.
While the recovery has been harder than my cancer surgery and my hip replacement combined I'd do it again.
When you had cancer, before the surgery.....were you given pain meds?
I think spinal fusion has a better success rate than the rod & pins I was offered and I denied. I've done better on my own than any of the Dr's I've seen over the past 2 years. Any of the pain meds prescribed didn't touch it, including Oxycodone.
My back is fucked and it sucks. I used to be a scratch golfer and had to quit playing. I used to get REALLY strong meds but now with the new laws and all the people that abuse drugs I only get 7.5's, 800 mg Gabapentin, Ibuprofen, and Tizanadine. the Tizanadine probably helps the most, especially in helping go to sleep at night... but when I wake up every morning I feel like I've been kicked in the back by a mule.
yeah, mine is too. L2 thru S1. Arthritis & Degeneration causing a slight curve and nerve roots, amongst other things. I have been given Oxycodone, Tramadol, Diclofenac?, Toradol injections and several others. The only things that did work were the Toradol injections......if the right nurse gave it in the right spot. Sometimes it helped & other times it didn't. Is supposed to work for 24-36 hours but usually lasted between 10-12 hours.
Also plain old fashioned aspirin......but taking 2 at a time, 4-6 times a day was putting my liver at risk and thinned my blood to water, so I alternated it with Tylenol. That is until I got hives several times and I quit the aspirin all together and trying a more natural approach. It's been a slow and painful process and I still have pain, and some days are better than others, but I haven't taken anything since November.
Thing is, my pain isn't so much in my back itself as it is in the hip area and down the left leg and it changes often (location, type & degree of pain, muscles/nerves, etc) so this leads me to believe there is more going on than just my back.........but several Dr's, including an Orthopedist & a Neurologist say otherwise.
Yeah that's called sciatica. I have the same thing. Last month I just finished my latest round of three injections. They only helped a short period of time and not long enough to continue doing them again. I've had 10+ injections.
I think spinal fusion has a better success rate than the rod & pins I was offered and I denied. I've done better on my own than any of the Dr's I've seen over the past 2 years. Any of the pain meds prescribed didn't touch it, including Oxycodone.
My back is fucked and it sucks. I used to be a scratch golfer and had to quit playing. I used to get REALLY strong meds but now with the new laws and all the people that abuse drugs I only get 7.5's, 800 mg Gabapentin, Ibuprofen, and Tizanadine. the Tizanadine probably helps the most, especially in helping go to sleep at night... but when I wake up every morning I feel like I've been kicked in the back by a mule.
yeah, mine is too. L2 thru S1. Arthritis & Degeneration causing a slight curve and nerve roots, amongst other things. I have been given Oxycodone, Tramadol, Diclofenac?, Toradol injections and several others. The only things that did work were the Toradol injections......if the right nurse gave it in the right spot. Sometimes it helped & other times it didn't. Is supposed to work for 24-36 hours but usually lasted between 10-12 hours.
Also plain old fashioned aspirin......but taking 2 at a time, 4-6 times a day was putting my liver at risk and thinned my blood to water, so I alternated it with Tylenol. That is until I got hives several times and I quit the aspirin all together and trying a more natural approach. It's been a slow and painful process and I still have pain, and some days are better than others, but I haven't taken anything since November.
Thing is, my pain isn't so much in my back itself as it is in the hip area and down the left leg and it changes often (location, type & degree of pain, muscles/nerves, etc) so this leads me to believe there is more going on than just my back.........but several Dr's, including an Orthopedist & a Neurologist say otherwise.
Yeah that's called sciatica. I have the same thing. Last month I just finished my latest round of three injections. They only helped a short period of time and not long enough to continue doing them again. I've had 10+ injections.
I think spinal fusion has a better success rate than the rod & pins I was offered and I denied. I've done better on my own than any of the Dr's I've seen over the past 2 years. Any of the pain meds prescribed didn't touch it, including Oxycodone.
My back is fucked and it sucks. I used to be a scratch golfer and had to quit playing. I used to get REALLY strong meds but now with the new laws and all the people that abuse drugs I only get 7.5's, 800 mg Gabapentin, Ibuprofen, and Tizanadine. the Tizanadine probably helps the most, especially in helping go to sleep at night... but when I wake up every morning I feel like I've been kicked in the back by a mule.
yeah, mine is too. L2 thru S1. Arthritis & Degeneration causing a slight curve and nerve roots, amongst other things. I have been given Oxycodone, Tramadol, Diclofenac?, Toradol injections and several others. The only things that did work were the Toradol injections......if the right nurse gave it in the right spot. Sometimes it helped & other times it didn't. Is supposed to work for 24-36 hours but usually lasted between 10-12 hours.
Also plain old fashioned aspirin......but taking 2 at a time, 4-6 times a day was putting my liver at risk and thinned my blood to water, so I alternated it with Tylenol. That is until I got hives several times and I quit the aspirin all together and trying a more natural approach. It's been a slow and painful process and I still have pain, and some days are better than others, but I haven't taken anything since November.
Thing is, my pain isn't so much in my back itself as it is in the hip area and down the left leg and it changes often (location, type & degree of pain, muscles/nerves, etc) so this leads me to believe there is more going on than just my back.........but several Dr's, including an Orthopedist & a Neurologist say otherwise.
Yeah that's called sciatica. I have the same thing. Last month I just finished my latest round of three injections. They only helped a short period of time and not long enough to continue doing them again. I've had 10+ injections.
The injections are pretty much a waste of time.
They first had me do six weeks of PT which was agony,then they went to the injections and finally surgery.
I think spinal fusion has a better success rate than the rod & pins I was offered and I denied. I've done better on my own than any of the Dr's I've seen over the past 2 years. Any of the pain meds prescribed didn't touch it, including Oxycodone.
My back is fucked and it sucks. I used to be a scratch golfer and had to quit playing. I used to get REALLY strong meds but now with the new laws and all the people that abuse drugs I only get 7.5's, 800 mg Gabapentin, Ibuprofen, and Tizanadine. the Tizanadine probably helps the most, especially in helping go to sleep at night... but when I wake up every morning I feel like I've been kicked in the back by a mule.
yeah, mine is too. L2 thru S1. Arthritis & Degeneration causing a slight curve and nerve roots, amongst other things. I have been given Oxycodone, Tramadol, Diclofenac?, Toradol injections and several others. The only things that did work were the Toradol injections......if the right nurse gave it in the right spot. Sometimes it helped & other times it didn't. Is supposed to work for 24-36 hours but usually lasted between 10-12 hours.
Also plain old fashioned aspirin......but taking 2 at a time, 4-6 times a day was putting my liver at risk and thinned my blood to water, so I alternated it with Tylenol. That is until I got hives several times and I quit the aspirin all together and trying a more natural approach. It's been a slow and painful process and I still have pain, and some days are better than others, but I haven't taken anything since November.
Thing is, my pain isn't so much in my back itself as it is in the hip area and down the left leg and it changes often (location, type & degree of pain, muscles/nerves, etc) so this leads me to believe there is more going on than just my back.........but several Dr's, including an Orthopedist & a Neurologist say otherwise.
Yeah that's called sciatica. I have the same thing. Last month I just finished my latest round of three injections. They only helped a short period of time and not long enough to continue doing them again. I've had 10+ injections.
The injections are pretty much a waste of time.
They first had me do six weeks of PT which was agony,then they went to the injections and finally surgery.
Yeah all that stuff is pretty much just part of a pain management treatment plan they are forced to go through in order to prescribe pain meds. I had to do the same thing. They also generally, but not always, make you do some kind of psychological assessment to make sure you aren't abusing your meds or have an addictive personality.
I think spinal fusion has a better success rate than the rod & pins I was offered and I denied. I've done better on my own than any of the Dr's I've seen over the past 2 years. Any of the pain meds prescribed didn't touch it, including Oxycodone.
My back is fucked and it sucks. I used to be a scratch golfer and had to quit playing. I used to get REALLY strong meds but now with the new laws and all the people that abuse drugs I only get 7.5's, 800 mg Gabapentin, Ibuprofen, and Tizanadine. the Tizanadine probably helps the most, especially in helping go to sleep at night... but when I wake up every morning I feel like I've been kicked in the back by a mule.
They gave me 100 NORCO after the surgery and another 40 after seeing the surgeon a few weeks later.
They did a good job of keeping the pain manageable.
While the recovery has been harder than my cancer surgery and my hip replacement combined I'd do it again.
When you had cancer, before the surgery.....were you given pain meds?
Nah...they found it by accident while getting an MRI and told me to come back in a few months to see if it was growing.
It had grown so they went in and cut a chunk off my kidney.
I think spinal fusion has a better success rate than the rod & pins I was offered and I denied. I've done better on my own than any of the Dr's I've seen over the past 2 years. Any of the pain meds prescribed didn't touch it, including Oxycodone.
My back is fucked and it sucks. I used to be a scratch golfer and had to quit playing. I used to get REALLY strong meds but now with the new laws and all the people that abuse drugs I only get 7.5's, 800 mg Gabapentin, Ibuprofen, and Tizanadine. the Tizanadine probably helps the most, especially in helping go to sleep at night... but when I wake up every morning I feel like I've been kicked in the back by a mule.
They gave me 100 NORCO after the surgery and another 40 after seeing the surgeon a few weeks later.
They did a good job of keeping the pain manageable.
While the recovery has been harder than my cancer surgery and my hip replacement combined I'd do it again.
When you had cancer, before the surgery.....were you given pain meds?
Nah...they found it by accident while getting an MRI and told me to come back in a few months to see if it was growing.
It had grown so they went in and cut a chunk off my kidney.
Same with hubs cancer.....he was having chest pains and a family history of heart problems (3 siblings died of heart attacks) so I made him finally go to a Dr. Seen the tumor during his x-ray. It's right at the entrance of the left lung and around the aerota leading into the heart and the bronchial tube into the lung and within the lung.......surgery is not an option. He's been thru chemo that did shrink the tumor somewhat, radiation, Opdivos for a year & a half and is now on a different treatment regime because it had started to grow again.
His initial prognosis was 2 months and we're now 2 years out.......but he's been on Morphine and Oxycodone all along and takes both several times a day. He is one of those that fall somewhere in between in this 'crisis'........yes he has the chronic pain warranting their use, but he's also addicted.
I think spinal fusion has a better success rate than the rod & pins I was offered and I denied. I've done better on my own than any of the Dr's I've seen over the past 2 years. Any of the pain meds prescribed didn't touch it, including Oxycodone.
My back is fucked and it sucks. I used to be a scratch golfer and had to quit playing. I used to get REALLY strong meds but now with the new laws and all the people that abuse drugs I only get 7.5's, 800 mg Gabapentin, Ibuprofen, and Tizanadine. the Tizanadine probably helps the most, especially in helping go to sleep at night... but when I wake up every morning I feel like I've been kicked in the back by a mule.
They gave me 100 NORCO after the surgery and another 40 after seeing the surgeon a few weeks later.
They did a good job of keeping the pain manageable.
While the recovery has been harder than my cancer surgery and my hip replacement combined I'd do it again.
When you had cancer, before the surgery.....were you given pain meds?
Nah...they found it by accident while getting an MRI and told me to come back in a few months to see if it was growing.
It had grown so they went in and cut a chunk off my kidney.
Same with hubs cancer.....he was having chest pains and a family history of heart problems (3 siblings died of heart attacks) so I made him finally go to a Dr. Seen the tumor during his x-ray. It's right at the entrance of the left lung and around the aerota leading into the heart and the bronchial tube into the lung and within the lung.......surgery is not an option. He's been thru chemo that did shrink the tumor somewhat, radiation, Opdivos for a year & a half and is now on a different treatment regime because it had started to grow again.
His initial prognosis was 2 months and we're now 2 years out.......but he's been on Morphine and Oxycodone all along and takes both several times a day. He is one of those that fall somewhere in between in this 'crisis'........yes he has the chronic pain warranting their use, but he's also addicted.
My back is fucked and it sucks. I used to be a scratch golfer and had to quit playing. I used to get REALLY strong meds but now with the new laws and all the people that abuse drugs I only get 7.5's, 800 mg Gabapentin, Ibuprofen, and Tizanadine. the Tizanadine probably helps the most, especially in helping go to sleep at night... but when I wake up every morning I feel like I've been kicked in the back by a mule.
They gave me 100 NORCO after the surgery and another 40 after seeing the surgeon a few weeks later.
They did a good job of keeping the pain manageable.
While the recovery has been harder than my cancer surgery and my hip replacement combined I'd do it again.
When you had cancer, before the surgery.....were you given pain meds?
Nah...they found it by accident while getting an MRI and told me to come back in a few months to see if it was growing.
It had grown so they went in and cut a chunk off my kidney.
Same with hubs cancer.....he was having chest pains and a family history of heart problems (3 siblings died of heart attacks) so I made him finally go to a Dr. Seen the tumor during his x-ray. It's right at the entrance of the left lung and around the aerota leading into the heart and the bronchial tube into the lung and within the lung.......surgery is not an option. He's been thru chemo that did shrink the tumor somewhat, radiation, Opdivos for a year & a half and is now on a different treatment regime because it had started to grow again.
His initial prognosis was 2 months and we're now 2 years out.......but he's been on Morphine and Oxycodone all along and takes both several times a day. He is one of those that fall somewhere in between in this 'crisis'........yes he has the chronic pain warranting their use, but he's also addicted.
You'll know when it is a serious issue, if he starts grinding them to snort them, or starts injecting them with a needle.
Predicted this and its already on the way. I am not in chronic pain but have had some recent experience being denied needed pain meds. Injured my hand at work which required two surgeries to fix, partly because they didn't do an immediate MRI and were working off just an x-ray. Forget the generic of what I was given, was oxy something, fake Percocet. After three days was rdy to rip cast off because I couldn't stand it anymore. Called ortho told em I need the real thing and got a series of lies, one was a med they had prescribed with the pain meds boosted the pain med and was I taking it. Problem is it doesn't say that anywhere except their take home instructions because I always check my meds out. When I informed her of this she got nasty and hung up. Dr then tried the there are so many formulations of it he cant waste time trying to personalize it to me. Go and ask the friendly pharmacist how many there were, 3.....
'We're treated like drug addicts': As America fights opioid addiction, the healthcare system is failing people who live with chronic pain
'We're treated like drug addicts': As America fights opioid addiction, the healthcare system is failing people who live with chronic pain
My back is fucked and it sucks. I used to be a scratch golfer and had to quit playing. I used to get REALLY strong meds but now with the new laws and all the people that abuse drugs I only get 7.5's, 800 mg Gabapentin, Ibuprofen, and Tizanadine. the Tizanadine probably helps the most, especially in helping go to sleep at night... but when I wake up every morning I feel like I've been kicked in the back by a mule.
They gave me 100 NORCO after the surgery and another 40 after seeing the surgeon a few weeks later.
They did a good job of keeping the pain manageable.
While the recovery has been harder than my cancer surgery and my hip replacement combined I'd do it again.
When you had cancer, before the surgery.....were you given pain meds?
Nah...they found it by accident while getting an MRI and told me to come back in a few months to see if it was growing.
It had grown so they went in and cut a chunk off my kidney.
Same with hubs cancer.....he was having chest pains and a family history of heart problems (3 siblings died of heart attacks) so I made him finally go to a Dr. Seen the tumor during his x-ray. It's right at the entrance of the left lung and around the aerota leading into the heart and the bronchial tube into the lung and within the lung.......surgery is not an option. He's been thru chemo that did shrink the tumor somewhat, radiation, Opdivos for a year & a half and is now on a different treatment regime because it had started to grow again.
His initial prognosis was 2 months and we're now 2 years out.......but he's been on Morphine and Oxycodone all along and takes both several times a day. He is one of those that fall somewhere in between in this 'crisis'........yes he has the chronic pain warranting their use, but he's also addicted.
Thats rough.
In some cases I think it's better to be addicted to pain meds than the alternative.
I know myself well enough to know I'd become addicted and the pain would have to be substantial with no other options for treatment before I'd go that route.
Predicted this and its already on the way. I am not in chronic pain but have had some recent experience being denied needed pain meds. Injured my hand at work which required two surgeries to fix, partly because they didn't do an immediate MRI and were working off just an x-ray. Forget the generic of what I was given, was oxy something, fake Percocet. After three days was rdy to rip cast off because I couldn't stand it anymore. Called ortho told em I need the real thing and got a series of lies, one was a med they had prescribed with the pain meds boosted the pain med and was I taking it. Problem is it doesn't say that anywhere except their take home instructions because I always check my meds out. When I informed her of this she got nasty and hung up. Dr then tried the there are so many formulations of it he cant waste time trying to personalize it to me. Go and ask the friendly pharmacist how many there were, 3.....
'We're treated like drug addicts': As America fights opioid addiction, the healthcare system is failing people who live with chronic pain
'We're treated like drug addicts': As America fights opioid addiction, the healthcare system is failing people who live with chronic pain
Predicted this and its already on the way. I am not in chronic pain but have had some recent experience being denied needed pain meds. Injured my hand at work which required two surgeries to fix, partly because they didn't do an immediate MRI and were working off just an x-ray. Forget the generic of what I was given, was oxy something, fake Percocet. After three days was rdy to rip cast off because I couldn't stand it anymore. Called ortho told em I need the real thing and got a series of lies, one was a med they had prescribed with the pain meds boosted the pain med and was I taking it. Problem is it doesn't say that anywhere except their take home instructions because I always check my meds out. When I informed her of this she got nasty and hung up. Dr then tried the there are so many formulations of it he cant waste time trying to personalize it to me. Go and ask the friendly pharmacist how many there were, 3.....
'We're treated like drug addicts': As America fights opioid addiction, the healthcare system is failing people who live with chronic pain
'We're treated like drug addicts': As America fights opioid addiction, the healthcare system is failing people who live with chronic pain
Last year I had surgery on the bones and nerves of my right foot. I was not prescribed any medication at all. The pain was phenomenal. It was the worst I experienced since my baby was delivered only this went on for days. Out of all my doctors, not a single one would prescribe anything at all. I begged. I am alone, if I have to go anywhere, including to the doctor, I have to drive. This wasn't chronic pain. This was short term pain. I asked for some pain medication as long as the surgical wound was still open. Nope. All I could do was lay in bed and wait for time to pass. It took 7 months because I needed additional corrective surgeries.
Now that It is over, and my foot is just deformed a bit, I told my doctors, all of them, that I could not forget or forgive the way I was treated. It is something I will never get beyond. Especially since there was never any reason for denying me relief. It was just no. The State won't like it.
I guess I'm not unique after all.
Sorry to hear that. That's the Catch-22 for severe pain. The 'real stuff' is really addicting but aren't many alternatives. Depending on the type of pain Marijuana can help.
