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DePuy, Food & Drug Administration, Health, Hip Replacement, Magnetic resonance imaging, Medicine, Nephew, Nephew Smith, New York TImes, Smith, surgery, Ultrasound, UNited States
Hi,
there have been many posts recently regarding Smith and Nephew and I would like you to share my story with your readers.
Maybe we can all pull together and start something?
I am in the UK, had my S&N left BHR in 2006, it never fully settled, pain was always an issue but I thought this was what I had to put up with, medical investigations showed no obvious problems, I was told after 2 years my metals were high but that it was nothing to worry about!!
Eventually it was decided in September 2011 that I would need it taken out and a THR, I was referred for an ultrasound and x-ray. The x-ray showed my pelvis had been worn paper thin on this side and I would need a bone graft too!
The ultra-sound showed pseudotumours, largest measuring 6×2 wrapped around my femoral artery! Blood tests revealed my cobalt to be 383 and my chromium 410.
This was when it was decided that my local hospital could not do the surgery and I have been referred to a hospital in the next county as the risks and complications were too high!
I have had an MRI to determine how much soft tissue damage there is inside and to see whether I will in fact be able to have my new hip straight away or wait without one for the tissue to heal.
I have a 4 hour appointment this month to discuss the findings!
My surgery is booked for the end of February 2012, 5 months after the findings determined my revision as urgent!
I have discovered I was not a suitable candidate [for a BHR] given that I am 5 foot tall female, I have also discovered that tests to determine effects were never fully reported.
This means I was a human guinea pig, used for medical experiement without consent.
No-one can say what long term health effects will be. I have partial hearing loss, blurred vision, dizziness, extreme pain (been on morphine for 3 months now), chronic fatigue, lethargic, forgetfulness, confusion ………. That is presuming I survive the removal of the tumour on my artery!
Like others I have sought legal advice to no avail.
Again, group litigation is needed and not enough people have come forward. I have contacted the press, to no avail, I have this week emailed the minister for health in an attempt to do something.
I will share that response when I receive it.
We all need to push our stories.
I am 43 years old and a prisoner in my own home!
I am a professional and cannot do my job, my wage was our main income. Let us all shout from the rooftops on this one.
I believe many cases are being revised ‘quietly’ to avoid compensation.
We, like DePuy victims should be compensated and I will not rest until I get justice for myself and ewveryone else who has suffered at the hands of these manufacturers.
Please feel free to contact me on tabather@talktalk.net
Bear in mind I am in the UK but this affects us all regardless of which side of the pond we live.
Tracey
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- UK surgeon warns public about dangers of all-metal hip implants, especially for women | Depuy Hip Recall (earlsview.com)
- US Drug Watchdog Urges All ASR DePuy Hip Implant Recipients to Get Identified and Lists the Most Common Symptoms of a Hip Implant Failure (earlsview.com)
- DePuy ASR NOT Safe – Aspiration Revealed My ASR Device Had Failed While Other Diagnostic Tests Were Still Reading “Normal” (earlsview.com)
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- Rottenstein Law Group Heeds Common Benefit Order in DePuy ASR MDL – Yahoo! News (earlsview.com)
- India State FDA Files Complaint against DePuy with Mumbai Police | DePuy Hip Replacement Lawsuit Information Site (earlsview.com)
- Another S&N BHR goes Sour – Brenda’s Story (UK) (earlsview.com)
- More Smith & Nephew BHR Problems (earlsview.com)
- More Smith & Nephew BHR Problems – Katie’s Story (USA) (earlsview.com)
- Bryan’s Story – 28 Years Old, Two Hip Replacements – One dud Smith & Nephew BHR (earlsview.com)
- Howard View – on a few things (earlsview.com)
- FDA Clears Smith & Nephew’s Single-Use Negative Pressure Wound Therapy System (medgadget.com)
- Smith & Nephew spins off N.C. biologics unit into joint venture Bioventus (medcitynews.com)
- FDA Clears PICO* Single Use Negative Pressure Wound Therapy System – Instructions for Application Use Provided by a MS Tag (barcode) On Packaging (ducknetweb.blogspot.com)
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- Howard Sadwin’s Story – a lesson in perserverance… (earlsview.com)
Earl,Can we begin maybe with the many who have found your blog and written their stories? There could be a petition,here on site to sign . Is there someone willing to compose one?I am not very good at this kind of thing. I too suffered and have put my life on hold because of MoM, Smith and Nephew implant. Many are shy about writing their stories , but it is easy to sign a petition. W/much empathy to everyone, Dodi
Hi Dodi
I think that is a good idea – I will have to see how many there are.
Earl
I am sorry for all the pain and suffering you and others are living through. Although I live in the USA, I am working on several different theories that may allow our goevernments to realize there is a common problem with the outcome of BHR patients. People from all parts of the world are suffering, unnecessarily because these devices were rushed on the market without regard to the quality of human life as a primary concern. Satisfying the investors was the primary concern, so do whatever you have to in order to sell our BHR.
In the USA the BHR was denied approval by the FDA, then two years later it was approved using the same data, just a different application process. The test group was foreign, controlled by one of the inventors of the BHR, who incidently worked for Smith&Nephew, and who incidently received a reported $50 million dollars upon the FDA approval of the BHR. This leads one to think there may have been adverse reports with held in order to get the device approved, after all Smith & Nephew paid $28-29 million fine to the Federal Government in order to stop an on going investigation of paying kickbacks. ( total fine was $311 million paid by the larger medical device manufacturers), and the kickbacks continued after the fine, as the Federal Government has an ongoing investigation into PODS, another means of paying kickbacks) Smith & Nephew is also being sued by the US Government on a whistle blower case. So they are not as saintly as they lead people to believe and for that they as well as other manufacturers must be held accountable.
Having justice served will require a joint effort, by all those that are suffering regardless of where you are from. This will take effort from all of us if we are to see changes made so this type of event won’t happen again.
Don’t give up, seeing justice served is demanding, energy draining, emotionally devastating but necessary if accountability and justice are to prevail.
Respectfully
Howard Sadwin
Tracy, I am sitting at home in agony 18 months post revision surgery with pain still in the groin (the tissue does not gow back) major pain the last 3 days around the implant and I think the muscles (25% damaged) have detached again from my pelvis as I have a very dull throbbing ache in the buttock (this happened before). Derek McGinn who Howard refers to as co-inventor of BHR states on his own website that metal doesn’t leave the body for up to 2 years post revision….so I guess read much longer. I have today (Sunday 8th Jan)phoned a solicitors advertising in UK for Du Puy re: S&N they said they would get back to me and they have some complaints about S&N but could not answer why no action is yet to be taken. Will keep in touch and I will try and email you directly but I agree we all need to join forces. I have had 5 years of this pain and am totally drained.
I have emailed you x
Pingback: Katie’s Full Story – Metal on Metal BHR Mess « Earl's View
Pingback: More Hocus Pocus around the Smith & Nephew BHR Metallosis Problems « Earl's View
Just to say I think a petition beginning with all of us here is a fab idea, I am up for that one! Could we maybe have a smith and nephew folder on the site where all our stories are shared? That would make it easier for each of us as individuals to print these stories and take to solicitors, gobernment, local papers, anyone who will listen, to show we are not alone in this! Everyone treats me as though I am the only one and I know I am not! For starters there are you lovely people all here! I do think once publicity is raised then more people will come forward. I am going to try every paper here in the UK to take my story! These manufacturers will not win!! It’s ironic that the Iron Man story happens as more people start to complain!
Anyone who wishes to contact me direct please feel free to email:
Does anyone know what the legal minimum number of complaints is to start group litigation? There is a solicitor here in the UK who took on and won a complex case close to me, this was against the NHS trust, tomorrow I will contact him on behalf of myself and everyone else.
We can and will fight this, together
Tracey x
I too am a petite woman and had 2 bhrs in 2008. Immediately I knew my right one wasn’t right! I ended up in Dec. 2010 having a THR but am still being monitored for metal ions for my left. During this, I found an article in the NY Times dated Nov. 2008 that studies in Australia and another European country were showing women and some men with small femoral heads were not good candidates for BHR and I was NEVER told of this risk. I live in Kansas City and my surgeon was McMinn trained. He told me that he isn’t doing resurfacing any longer on petite women…I worry about my metal ion count as it is still fairly high… I wonder if there will be any financial restitution for all of us that have had or are suffering from experimental surgeries.
Pingback: Alison’s story – BHR’s don’t work for petite women – read on… « Earl's View
Pingback: Mark’s Story – another Smith & Nephew BHR disaster – 18 Months « Earl's View
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Pingback: Harold’s Story – Smith & Nephew BHR – Pain & Tumour – Revision… « Earl's View
Pingback: UK hospital recalls all Smith & Nephew Birmingham Hip Resurfacing Patients… « Earl's View
Pingback: Another US Smith & Nephew BHR problem « Earl's View
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Pingback: Michael’s BHR disaster – life in tatters – when will it stop! « Earl's View
Any thought of adding a ZIMMER impant to the registry of failed hip replacement. I am in constant touch with them, and because I have a medical malpractice Review pending with our ludicrous hypocritical Acc (cannot sue-individually in small NZ. Must go throught the ACC process, wgich adds to the stress, the depression and the constant assesments, whilst providors ALl arguing with each other, as to whom is right-who is wrong, leaving me EXACTLY where I started out, and was a proceedute I fely so uneasy about-to try and exit hospital ‘after no explanation ofwhy long, unacceptable delays and no opportunity to meet to didcuss anaesithic proceedure-let alone become informed on the surgical process. Denied until last minute (just as I was signing out,(Several postings on this site-after Earl discovered, and approached me.His information on ZIMMER products served me well, and took the intiative, of liasing directly with a whistleblower, and back and forth with a Zimmer spokesperson, in what ammounts to a fob off, as I am withh NZ ACC, but released certain information re the surgeon’s purchase of my implant (see Jills seven years of hell” Nothing has been resolved, but I do know, was filled with so much unwanted junk, wrong sized femoral head,bone cement is under suspect currently -and what the mixture comprises of-is mind blowing, and a cocktail to didaster to afix prosthesis to the bone.I can feel the loosening, wear a corset to hold in, cannot walk more than 100 metres, and can feel the stem, too long-down my thigh. All this after request, and 20 min discussion, with agreeance to NONE of the extreme lengths -he went to to try and afix implant. and one 20min discussion ie no leg lengthening that went ahead anyway, NO CEMENT request, but was plugged up so heavily, with just what was agreed against. So much life threatening damage complications with systemic side affects to jeopordize health as well as disability. I CANNOT have a replacement-as he has cut too much of the femoral head This surgical team took away my life overnight (rea-action was immediate) with toxicolgy results high.I leanred yesterday-that instead of further help-as a now NON EARNER-I am being thrown over to another rehabilitation programme, IF my current GP will sign my life away, which he is reluctant to do currently.
I know what is needed, in the rehabilitation game, and after 7 half years, of a miserable, pain wracked existemce,fighting for justice, I am thrown on the scrapheap. Cant even drink now,as healthy kidnreys impaired dramatically.I have my say on many medical websites, but ‘more than that is needed, I will help anyone, that needs help,and the motivation to carry on and see justice.Please consider adding ZIMMER to the list, also for all out there, we need to stand as voices in unity,
Empathy for all, anywhere, under any circumstances,
I share Howard, Earls.and all comments and identify with ALL case histories on this site. Finding comments on Vicky Morron’s platitudes, hard to swallow and.to ludicrous to repond to.There are many vicky’s out there, but I thought they were isolated to the ACC corporation., From now,after 73 assesments, I have come across the ODD Vicky replica, out there, but 90% providor reports to the contray. Othropaedic world in world of NZ-seem still in denial,Any petition organised, I will distribute, anwhere. Justice needs to be seen to be done for ALl of us, defening their surgeons, and the products they buy. When will it stop. Jill.NZ
Pingback: Joann’s Story – another BHR Disaster – they keep coming… « Earl's View
Heya. I’m in the UK. I had my right hip re surfaced with BHR in November 2009 and I has never really felt right. I am also only a 5ft 1inch female and 43 at time of operation.
I have arthritis in my other hip and both knees (the left being worse) and also 2 prolapsed disks.
I admit the BHR has had a hard two years as I struggle to walk even a short distance cos of the arthritic joints and that being my ‘good’ hip has taken the brunt of it.
Recently the pain in the BHR hip has got really bad and I have very limited movement, as bad as before it was done.
I am on a huge amount of drugs but I am still in pain, all over my body I hurt and I hate being touched as that hurts too! I am extremely fatigued all the time. I just don’t know what to do with myself anymore. I did complain once and had X-rays done which I was told was normal looking, but it wasn’t an Orthopaedic person that looked at them just a normal Dr so how would he know what’s what.
I was made to feel like a complete idiot when I complained and I don’t think I could do it again just to be made to feel like a twit.
Hi Sylina
you need to get to an orthopaedic surgeon ASAP – and have various scans. More than likely you have a range of issues associated with cobalt chromium poisoning.
Don’t wait around – get a referral ASAP for the sake of your health. It won’t get better unfortunately.
Regards
Earl
Hi Sylina, what you are describing is exactly what I went through. You need a blood test checking specifically your cobalt and chromium levels. My xirays looked normal, it was only once surgery was discussed that I had an ultrasound and then an MRI which showed the full extent of the damage. You need to talk to an orthapeadic surgeon and request ultrasound and MRI too.
You don’t say what part of the ul you are from. I am in wiltshire. Please feel free to contact me if you would like to email:
I am 4 weeks post op and feeling it. My recovery has been slower than when I had BHR. I haven’t had a full report on the op, I see consultant next month. I had my BHR removed and aa THR ceramic on ceramic. I am still very swollen and sore. Still on a huge range of meds and generally feeling sorry for myself! I have solicitors looking into this for me, they are covering quite a few of the people from UK I have made contact with thro the site. They are also communicating with Howard Sadwins attorney in US.
Wishing you luck with the tests, please do get in touch if I can do anything or you want some advice
Tracey x
Thanks Tracy and Earl. I will have to make a fuss at the doctors as they seem to think I’m just complaining about nothing but I’m not. I’m having back injections on Friday so I am going to have a chat with my pain consultant as he DOES listen and he might action something for me.
Tracy I am in Berkshire so not far from you. I will email you.
Adding to this. Here in NZ-The Orthopaedic world-plain and simply DO NOT WANT TO KNOW. They maim,and cripple us. leaving a wake of bizarre and unexplained medical problems, previously unknown’ and render previosly ‘active-energetic’ patients who lived life to the full-rendering so many of us
disabled, with need for assistance in every day function in
life. The grief, loss of any quality of life,, with at times, a degree of depression, at the lost life style, that was STOLEN OVERNIGHT. With no concerns adressed by either
surgeon OR anaethitist, who went against ALL requests, and against x-ray results (mild, early osteo changes) insisting on ‘the need URGENTLY for immediate THR, to take place (private hospital) where the dollars are large and the service NIL. Immediate concerns expressed-were taken no notice of ‘in the quest’ to hurry through-with this debatable needed surgery. Even talked of HIP REVISION within the first 5 days, whilst still in hospital.
This battle still continues, for recognition of ALL that occured in surgery of 6/9/2004 -YES (Into eigth year-with life as I knew it-STOLEN OVERNIGHT, whilst the offending surgeons/anaethitist ‘hide behind the ‘cloak of protection’ offered them through Insurance cover (In NZ-Its our ACC) Another story, and contensios battle on its own,
with unaccepatble life threatening side affects (we are all aware -of high toxicollogy results) with prior excellent BP that never returned to normal, raging temeratures, with 10/10 pain.We survived to tell the story,whilst too many professionals, continue burying their heads in the sand. Angry, frustrated,pain wracked,with no longer a quality of life-With help, and legal advice, I have spoken out, along with many others, and with Earl’s assistance, on this Blog and other medical sites. (See Jill’s 7 years of hell, and other related comments,on this site-and others.
We can no longer trust ANYONE from Orthoepedic world, and is only OUT of NZ, That the majority of assistance comes from.
Willing to speak out-on any forum,that has vested interest,
in surgical error (Medical Misadventure), and willing to back, any others seeking, answers, redress, and accountability. Can be reached by email, skype, or phone.
Jill.NZ
Hi fellow MoM hip victims. I discovered this site a while back, and had bookmarked this page so I could easily find my way back to this great site. I haven’t heard anything since I read this — I was coming here once every few weeks and then had a Smith and Nephew BHR THA revision about a month ago, so maybe this idea of a sort of failed registry is still on the back burner.
Perhaps we should write a blog/poll specifically addressing this issue, asking people to respond directly to a list of questions, about failure rates, revisions and their new composition (My doc doesn’t use MoM devices any more, for instance, and upon revision gave me a Zimmer Continuum Acetabular Shell, (60 mm outer diameter), a couple 6.5mm cancellous bone screws into the pelvis and a 40mm polyethylene liner covering them within the new cup. They had to go 60mm on the new cup because the one they beat out of there was a 58mm BHR Acetabular shell (I don’t know how much deeper then can ream into my pelvis now). My old 52mm BHR modular head was replaced with a smaller Oxinium (Oxidyzed Zirconium) femoral ball, and since it was part of the Anthology R3 System (Mix and match heads, leave the ‘versatile stem in). So they left that Anthology femoral stem in and pounded the old ball off of the neck of the it, and while you could say my revision was less complicated because that stem was allowed to stay in, (big selling point, I’m sure), it was literally hammered on (to remove the old Oxinium ball) and seat the newer, smaller one. It still throbs as I sit and type this and was a swollen as a Python that had swallowed an Alligator. Another noteworthy chage is much smaller balls and cups, as the big ones were very prone to dislocation (I know a woman who’s dislocated three times in the first six months and had to then be revised. Her’s is a story from hell, and it yet continues). To add to my story, I had horrible metallosis (two pseudotomors that were growing around and out from the head/cup junction of my implant into the surrounding tissue that required excision, both issuing forth from the implant and were beginning to cross my inner thigh — plus they hurt like hell (I don’t really see how hell could hurt more than all of this crap, this living hell these device manufacturers have subjected us to in order to increase market share and dividends.
This brings me back to what i was trying to say, which is that while we all have these stories that not only need organizination/compilation here on this site, most importantly they need to be told to whatever protective health organization we have in our individual locations, MHRA, FDA, etc. They need to be told to as many people who will listen, by whatever means.
That is why I posted these past few days off of this link from the my countries ‘watch dog’, the very careless FDA:
http://www.fda.gov/AdvisoryCommittees/Calendar/ucm297884.htm
If we do nothing else in the next nine days, let us send our stories to this FDA committee meeting where the truth might see the light of day, or at the very least catch the eye of someone who cares about protecting their fellow humans from predatory medical device manufacturers who see those very humans as their testing ground. I was not told anything about metal on metal, wasn’t warned about metal ions and pseudotumors, etc. when I got this thing in 2009, and there existed a large body of medical and orthopedic literature warning of very serious pitfalls and undesirable side effects from MoM devices. Presumably mine was put in (just three months after approval for use in the sates) because of that new wonder alloy, Oxinium! This alloy may be harder and demonstrate less wear on a hip simulator — that’s right, it’s tested by simulating hip movement on a machine, rarely in a humans body — but it releases metal ions nonetheless, witnessed by my recently excised pseudotumors during revision. In fact, with a magnifying glass you can actually see the abraded part of the metal, wear visible on two surfaces (I keep anything they revise, and I’ve been down ‘revision street’ three times. This ball and cup (It”s hazardous material!, the hospital warned, suggesting I shouldn’t handle it but rather send it back to the honest manufacturer to tell me what went wrong.
Not this time. This time my hazardous device (flesh and blood are clearly visible in the area from which ‘sprang’ the mass of metal [metallosis] that had to be cut out) will be examined by an independent laboratory, and impartial experts will speak of what they discover without fear of rocking the boat.
All of the above is part of my story, which I’m working on. I have researched the web extensively since I learned of my condition, I have found PowerPoint Presentations from Smith and Nephew salesmen given at orthopedic symposiums, with beautiful colors and convincing commentary, and most importantly I have all of my records on this latest THA and revision, I have consent forms I signed that said nothing about any danger from metal, I had no information with which to give informed consent.
So I hope until we get it together as a group and establish a database of revisions, etc., I think the best thing to do is learn all you can about what they did to you, what your records say, what your device looks like after revision, and most importantly how these things in total have caused all of us great pain and suffering and in many cases permanent damage. And while I hope I’m not coming off like the HIP Story Commander, I need you and you need me to write up our stories in as much detail as we can, and whatever we come up with in the next nine days we should send in to this FDA Committee meeting.
Even if you’re on the other side of the planet from me (like this site’s founder Earl Stevens), the more each regulatory body hears the closer we will be to total recall of all MoM medical devices. Please work up what you can and send it, and I just finished my formal complaint with the FDA (including serial and lot as well as model numbers) and am close to having a fairly cohesive but informative account of what this nightmare has been like. And I will send it to whoever wants it, and even some who don’t. But the next place I’m sending my story to is:
http://www.fda.gov/AdvisoryCommittees/Calendar/ucm297884.htm
Feel better, my friends
Hi Tracey, I just read your story again, and I couldn’t believe how long this string was that followed your post! Unfortunately, some windbag named Brooks came on and that was the end of that! But the heartfelt energy that became the string, or that the string became, is what can most benefit the greatest number of people — an open and honest collaboration between all who have suffered due to a failed MoM hip implant. All of us sharing our horror stories, typing ‘em in from wherever we happen to be on the globe at the moment. I think I had just found this site a few months before I saw your story, and I wanted to understand this MoM nightmare, so the Google Machine brought me to Earl’s View. I loved Earl’s wit, his story, your story, Howard’s story, Stuart’s Story (Stu’s again front and center) — and the stories of many others, who were going through more often then not the exact same thing i was. I related to exactly these experiences because I had endured them, and if this metalosis monster hasn’t grabbed a hold of ‘ya you can have little to no idea of what’s even being discussed. And I count most prominently my surgeons amongst those not aware of what has happened to our bodies, and here I speak of the litany of symptoms that are part of this ‘new’ Health syndrome, and yes, most unfortunate of all is that this metalosis syndrome is so new, even your doctor has yet to hear!
So I was — well, am — way over in in the US (oh, what a great and glorious health care system have we here, where one is afforded the opportunity to pay for one’s THA twice in just three short years! What a bargain! Can I get a deep depression to go with that, Dr. Know-Little)? And ‘pitting edema’ immediately after you cut the AVAL loose,etc., where I might land in your emergency room as this ooze migrates down the fascia of my operative leg, swelling to the point of bursting two weeks post-revision. And now, I find, I may be looking at yet another revision, with ‘may’ being the operative word as a result of my surgeon simply not knowing!
I could tell it was a good place to be, a place Earl had created where our voice would be clarified and made louder. The similarities in the stories help make the matter clear, clear for all to see. THIS is what is happening to ALL of us, and we are but the tip of the iceberg. Yes, we are guinea pigs. No, they don’t care about us. Yes, we were/are the active MoM recipients unlucky enough to have come along at a space in time where we would be the first people actively participating in such a horrid experiment. We have had the pleasure of actually using these ‘long-lasting’ MoM devices (My car’s drive-train at least gave me three year’s warranty)! At Earl’s View results are coming in more and more frequently, from more and more MoM victims all around the globe.
So for me, I just want to share as much BHR detail with you — this would include any current complications (which seem to be all I’m having presently) and hopefully any other BHR and BHR THA patients, regarding recurrences after MoM revision of pseudotomor/AVAL — [aseptic lymphocyte dominated vasculitis associated lesions] — “which are more like fluid than they are lesions, but we doctors are quite nearly as stumped as you folks are, so please pay your bill and wait for our call”. Your prognosis, doc? “Well (shaking head) — I’m just not sure. Why don’t you come see me again in two months or so. Like I said before, we’re sailing in uncharted waters here”, (I’m thinking ‘who is at the helm’?), “and we now think your pool of fluid” — like Howard says they speak to us as if our bodies were cars — “we think that weird, watery-lesion, surrounding that NEW implant of yours is getting smaller. So that’s good news”. Oh yes, yes, absolutely it is, doc!
I’m sorry, but I have to humor myself somewhat in the midst of this bad movie my life has become, or based again on experience suffer the consequences. Another bad side effect for all MoM folks that is not even considered part of the equation, just simply not calculated. So I write ‘lines’ I’ve really heard from my physicians, and am admittedly at times somewhat sarcastic.
I plan on doing what I can through Earl’s View to get the word out about this crime, and shout it out for all of the people to hear. All of the people who may have been similarly lied to and left decimated in this charade, regardless of their respective positions around the globe.
I sent you an email today, and I hope you have some ideas as to where we both might apparently be headed, although we can’t be certain. And of course neither can our doctors, I’m sorry to say. I want to add that if any other S&N revision people want to share with us please email Earl through the ‘contact’ button and he will connect us with one another.
You stay strong, Tracey! And I stay strong, & hopefully we all stay strong. And that’s how we’ll all help each other get through this thing.