Women’s Health Interactive Forums

  • If this is your first visit, be sure to check out the FAQ by clicking the link above. You may have to register before you can post: click the register link above to proceed. To start viewing messages, select the forum that you want to visit from the selection below.

Announcement

Collapse
No announcement yet.

Essure and what to expect

Collapse
X
Collapse
  • Filter
  • Time
Clear All
new posts

  • Essure and what to expect

    it would be nice to get a wide perspective on what goes on during the procedure and afterwards.


    17 Sep 2009

    6 AM I woke up feeling nervous and had to lay on the bed for a few minutes to keep from fainting. I took a shower, took one of my anti-anxiety medications, and drove to my parents house where my friend was picking me up from. Threw up on the way due to nervousness.

    7 AM Took the two vicoden prescribed to me and another anti-anxiety pill. My friend picked me up and drove me 45 minutes to the hospital. About five minutes away I felt faint and had to lay the seat down and prop my feat on the dash.

    7:50 AM I got out of the car and had to lay on the ground in the parking garage or I would have fainted. Medication was not helping. A doctor who walked by contacted security and stayed with me. Security gave me a vehicle escort to the door. I managed to walk to the elevator where I fell to the ground and almost blacked out. I got up to the 4th floor and my friend carried me to the waiting area and checked me in. I felt sick and had to crawl to the restroom and threw up the vicoden.

    8:15 AM Finally in the doctors office where I got a high dose of Ibuprofen in the arm and a shot of lidocaine in the cervix.

    8:30 AM Medication kicked in and the procedure started. I never had kids so it was difficult getting my cervix to dilate enough to get the device in. After a lot of persistence on the doctors part and quite a bit of pressure pain from me (felt like really bad bloating cramps during your period but just a bit worse) the doctor was able to get in. After about 3 minutes the first coil was in. The second coil took a bit longer.

    8:45 AM Procedure was done and everything was removed. Pressure pain slowly went away and I felt really tired. It looked like a lot of blood on the drop cloths but it was mixed with the saline used to help place the inserts which made it look like there was more blood than there really was. They got me a wheelchair and my friend wheeled me to the car. I fell asleep on the way home and took a nap as soon as I got there.

    4 PM I woke up from my nap feeling like nothing happened. I had a slight bit of spotting.

    8 PM Wrestled with two dogs (115 lb Rottie and 45 lb American Dingo mix) and no pain.

    Day 2 Very Slight spotting. Barely noticeable. Back to work (armed security) at 4 PM.

    Day 3 Spotting stopped completely.

    Day 6 Began running again. Felt occasional slight pinch during run and had to slow down. Nothing too bad. Also, did some push-ups and sit-ups. No pain during those.

    Day 9 Began period. It was lighter than normal with no cramps but darker. Almost like the last day of your period.

    I am scheduled for a follow-up on 16 Oct 2009
    14
    Great
    35.71%
    5
    Good
    28.57%
    4
    Fair
    0.00%
    0
    Bad
    35.71%
    5
    Last edited by CHANDLERS WISH; 09-26-2009, 03:04 AM. Reason: some areas are already on topic in another thread

  • Essure experience

    I actually had some minor complications and had to have the procedure done twice. I think it may have had something to do with where I was in my cycle and the fact that my doc removed my IUD (paraguard) in the same visit. So here's my story:

    First round (April 2009). I had started the pill and still had the IUD, so my uterine lining was abnormally thick, part of the reason why this may have been so difficult. So first piece of advice - make sure you've just finished your period before getting this done. He put me in "twilight" anesthesia via a mobile anesthesia service that operates in-office, so I was out the whole time but here's how he told it-- It took him an hour to place the right-side insert because my fallopian tubes started spasming (something I never knew was possible). He finally got the right side in. The left side also took over an hour and kept sliding back out because of spasms. He finally gave up. When I came to, we discussed my options. I decided to wait the 3 months and have the HSG on the right, completed, side to ensure that worked. If it did, then we would schedule a second appointment. If it, for some reason, didn't work, then there would be no point to doing the left side. I experienced no cramping, a tiny bit of spotting for a couple of days, and that was that. No problems at all (other than the incomplete procedure). My doctor said it was the most difficult placement he'd ever attempted.

    First HSG Test: Talk about WEIRD. I can't even begin to describe the tools that were laying on the tray - It seemed like some weird horror movie. This hurt more than the procedure itself, because I experienced cramping when they pushed the dye through. It was cool being able to see a real-time x-ray of my body on a tv screen and watch the dye move. The right side insert was completely blocked and successful. So we scheduled the second insert appointment.

    My doc recommended me being awake during this one, since he thinks the anesthesia may have been a contributing factor to the spasms.

    Second insert appointment - last week (Sept 2009): MUCH easier. Several factors contributed to that, I think. 1) being on the pill for several months with a regulated cycle. 2) the appointment was for the day after my period ended. 3) no IUD to remove at the same time.

    For those considering the anesthesia vs. awake method, I can say awake was a better experience for me, overall. But everyone is different.

    I took a small dosage of a drug to start softening/dialating the cervix the night before the appointment (mysoprostol?). I took a vicodin and a valium 1 hour before my appointment (highly recommended combo - great for parties, I'm sure . Then, they gave me a shot of liquid motrin which was DEEE-LISH. Never having had any major surgeries or medical procedures before, I was unaware of how nifty pain medication could be.

    Here's the worst part: The shot they gave me to numb my cervix and that was SO not pleasant. It's ironic that something that is supposed to prevent pain can cause so much pain. Thankfully that was over quickly - but just be warned - that part SUCKS.

    This time, he had a rep from the Essure company in the room just in case there were complications and she could advise. They set up the procedure and I felt a little bit of pressure, but no pain at all. I got to watch on the monitor as the insert was placed. This procedure, from start to finish not including the prep work, took 20 minutes. Compared to 2 hours. I have experienced more spotting this time than last time and am going to call my doctor tomorrow if it does not subside.

    We'll never know if it was just bad luck, the anesthesia, the IUD, or a combination of factors that made the first appointment so difficult. But just be warned that you might have to go back.

    I go back for my second HSG in three months.

    Overall, I'm happy with the procedure. It's a great option for women who are positive they don't want any (or any more) children and don't want to rely on other methods of birth control that have various side-effects and risks.

    Comment


    • 27 Sep 2009

      Began my period. It was a bit heavier but less painful and only lasted 4 days instead of 5 or 6 and I didn't have a break day in between like I normally did. I couldn't use my diva cup and I ended up changing pads every two hours because they were just soaked. By day 3 it was like a normal period but the first two days were crazy.

      07 Oct 2009

      Woohoo, I had sex for the first time since the procedure. Still using birth control of course. I was thrilled to find out that it wasn't painful and had absolutely no effect on my sex life. I got my one month follow up this Friday so we will see how that goes.

      Comment


      • Essure Procedure

        I noticed a few questions from women wondering about the Essure procedure and wanted to share mine. I'm 41 years old and my kids will be starting high school next year. Like a lot of people, I've been on birth control pills for the better part of twenty years and have been wanting a more permanent birth control option for the last year or so. My husband and I considered tubal ligation and vasectomy but didn't really feel comfortable with either option.

        10-07-2009: After hearing about Essure, I did some research and made an appointment with an OB/GYN in my area who is licensed to perform the procedure. The physician I selected has performed quite a few and has been doing them for over five years--which I think makes a great deal of difference in your overall success rate and experience. During the first appointment, the doctor answered my questions and explained the process in detail. He also performed a speculum and bimanual pelvic exam to assess the position and condition of my uterus and cervix. I made an appointment for the following week and he gave me a prescription for pain medication to take prior to the procedure.

        10-13-2009: I ate a light breakfast and took the tablet of Phenergan (anti-nausea), Valium (anti-anxiety), and Vicodin (pain relief) an hour before the procedure. I arrived at the doctor's office and was checked in by the nurse. She administered a shot of Toradol (NSAID to reduce muscle spasm and cramping). She also conducted a urine pregnancy test to ensure that I wasn't pregnant. After confirming that I wasn't pregnant, she gave me a shot of Depo Provera which should last until the follow-up HSG test. She asked that I undress completely from the waist down and gave me a sheet to wrap around me.

        The procedure was performed in a regular exam room in the doctor's office which was cozy and beautifully decorated and did not feel at all like a cold, sterile hospital environment which was really nice. They had a chair next to the exam table for my husband to sit in and so he could rub my shoulder and hold my hand which I also appreciated.

        The doctor started by helping my into the lithotomy position (similar to the position you're in for an annual exam or pap smear test). He inserted a speculum into my vagina, and swabbed the cervix with an antiseptic solution. He then gave me three injections in my cervix to help numb the area (paracervical block). The first two injections were somewhat uncomfortable like any shot would be, but the last one hurt quite a bit more. I'm not sure if it was the location or the depth of penetration that made a difference, but it felt different than the first two. The good news about shots, is that even when they hurt, the pain is pretty quick and over with. He then waited for a few minutes for the injections to set in and numb up the area. The nurse stayed with me the whole time, talked to me and was setting up equipment during that time.

        The doctor returned to the room and talked me through the next few steps. He inserted a cervical dilator for a few minutes to help my cervix expand to accommodate the hysteroscope. The dilation did not hurt, but did result in some mild cramping. After removing the dilator, he gently inserted the hysteroscope into my vagina, through my cervix and into my uterus. They positioned the monitor so that I could watch the procedure and explained what we were seeing. The doctor used the scope to assess the uterus and to make sure that both tubes were open before placing the Essure implants.

        The first implant went in quite easily; but the second one was a little more uncomfortable and took longer simply because one of my Fallopian Tubes was sitting at an odd angle and it took more maneuvering to get it in place. At this stage in the procedure I was feeling some moderate cramping (similar to bad menstrual cramps) and also in my legs. If you can, I'd ask about having them use the kind of stirrups that fit under your knees and support your thighs and calves a little better. I think that the regular feet stirrups (while they work well for an annual exam) are more difficult during a procedure simply due to the length of time your legs are in that position.

        Once the implants were in place, the doctor checked their position visually with the camera one last time just to make sure everything looked right and then withdrew the hysteroscope. He used a few more swabs and antiseptic gauze to wipe me down, removed the speculum, and helped me move my legs into a more comfortable resting position on the table.

        The total time (start to finish) for the whole procedure was 30 minutes. The actual hysteroscope time from insertion to withdrawal was 13 minutes. The only difficulty I had was that my blood pressure dropped significantly at the very end of the procedure which resulted in my feeling dizzy, light-headed, sweaty and on the verge of fainting. The nurse was terrific during this whole time and reassured me that I would be ok and to lie still until I felt better. She brought me cold water and my husband held cold washcloths on my forehead and arms, which helped a lot. Nothing you can do about a vasovagal response--but I felt bad because I had done so well through the whole procedure and felt like a little bit of a wimp to have crashed right at the end! They let me rest until my blood pressure resumed to normal, and then my husband and I drove home. I did have some fairly painful cramping right as the procedure was ending, but it had subsided almost completely by the time we headed home.

        I was sleepy from the medication and took a three hour nap that day, but returned to work the next morning. The nurse and doctor had told me to expect some cramping and bleeding, but honestly, I had very minor spotting for the first few hours and then nothing after. The cramping lasted for only an hour or two after the procedure and by the next day, I physically felt great.

        I also like that this OB/GYN does his own follow-up HSG's, which is reassuring. (I have a sister who is a radiology tech, and she said HSG's performed by GYN's as opposed radiologists tend to be much more comfortable for the patient). When I asked about it during my initial appointment, his response was 'most of the radiologists haven't been on the working end of a speculum in ten years, and I won't put my patients through that kind of discomfort.' A doctor with a good sense of humor is always a plus!

        I know everyone's experience is different--but overall, mine was very positive. I think a lot depends on the skill, competence and bedside manner of your doctor and nurse--so do your research and get recommendations. The team that took care of me was terrific. The benefits for me were: no hospital stay, no general anesthesia, no scarring, short recovery, highly effective, and my husband could be there for support.

        I'll go in the first part of January 2010 for the HSG, and hopefully, all will be well. If any of you have opted for Essure and have been through the HSG, I'd love to hear from you in regard to your experience so I know what to expect!

        Comment


        • 16 Oct 2009

          I had my follow-up apointment and it went great. No infections or swelling. The doctor joked about how I reacted to the vicoden and explained why I felt so dizzy and sick when I had the proceedure done. Apparently it lowers your blood pressure which makes you drowsey. She asked about my recovery and how the pain and bleeding were after the proceedure and took notes. Then she scheduled me for the HSG test which I will have on 9 Dec 2009. I can't wait. Just like LRP in Idaho's doctor, mine also does the HSG's herself which I feel very comfortable with.

          Comment


          • essure birthcontrol-havnt had a period yet!

            i had the procedure done sept.2oish of 09 and i started the nuva ring a week b4.the procedure wasnt bad i recovered late that evening.bled 2 days 5 days after it was supposed 2 b safe 2 have intocourse so i did .the day i took the nuva ring out because of bleeding i bled for atleast 5 days heavy.put the ring back in for about a week &took it out waiting for my period and im still waiting it usually comes by the 10th and its now november 9th still very late.im not pregant but i asked the ob nurse she says this is normal &probly due 2 the ring.and i asked what if i dont have one by 3months(oh it would still b normal,the dr would only concerned if u were pregant)i never put another ring back in ,but i dont really understand why im not having a period.has anybody elses been that delayed

            Comment


            • I just had my HSG test today and found out the Essure worked and my tubes are completely blocked. I did have some problems though. Turns out my cervix is the longest my doctor has ever seen and it kepts pushing the catheter out. It was hard enough for her to get it in and hurt about as much as the proceedure but again my doctor was persistient and she managed to get it in. Here is a picture of one of my HSG images in case anyone has never seen one. You can see the big black spot which is the cervix but it doesn't go into the tubes. You can still see the tubes which are black but if it had not worked the dye would have leaked all over and the tubes would have been more prominent. I have an appointment a year from now just to follow up but as of right now everything is great. I would definetly recommend this to anyone who is skeptical of surgery. I was lucky to have a great doctor and very knowledgeable staff that worked with me and I would highly recommend Dr. Connery to anyone in the Tampa Bay area.

              Comment


              • Correction, the thin lines are the essure coils at the entry points to my tubes. You can partially see around the edges (the very pale white puff around the coils) where the tubes themselves are. Had the procedure not worked these would have been filled with dye. I read on several forums that the dye used was a sugar based and that it was very sticky. My Doctor actually used iodine and it wasn't bad at all. They gave me a pad to wear afterwards and a towel to clean up with but the amount of blood from my cervix being opened and the dye wasn't a whole lot at all. They said it would be normal to spot for about three days. So far I've had very very little spotting. Not even enough to have to use a linner. From start to finish the whole thing took about 16 minutes. Most of that time, about 15 minutes was spent trying to open my stubborn cervix. I did used 800mg of ibuprofen for 12hours before since it was recommended by someone else on another forum and I'm glad I did but I'm sure anyone who has had kids before probably won't have the same problem. Another piece of advice for anyone getting the procedure done is to make sure they give you the cards. I don't post anymore in the Essure failure forum but I do read them and keep track of what to keep an eye out for and I've noticed many of them said they did not get the cards. The cards keep track of the serial number for the coils. Sort of a legal tracker in case something goes wrong. Mainly though the are used in case you have any pelvic problems the doctor will be informed and can contact the doctor who did the procedure or Conceptus and work in conjunction with them to resolve any problems. Also, it's a good idea to update your emergency data cards if your work has them. If you are injured at work you want someone to be able to give EMS or the hospital a heads up for what to look for. If they do x-rays and see the coils they could mis-diagnose. Not something I would have thought of except I was filling out my EDC for a new job and it occured to me.

                Comment


                • I had Essure Done Today

                  I had the procedure done today at my doctor's office. There was some concern that they would not be able to do it because I started bleeding over the weekend, but after some complications it was complete.

                  Here's the run down.....

                  I ate a very light breakfast at about 7am. Showered, at then took Zantac and 800 milligram Motrin at 8am. I arrived for check in at 9am and was given a Valium and two Percocet.

                  They gave me some magazines and a nice pillow and I rested for about twenty minutes until the meds kicked in. I was taken to the surgical room and was joined by my doc, two nurses and the Essure rep. I've never had so many people looking at my vagina at once! lol

                  The doc gave me numbing shots around my cervix which pinched a bit. They had difficulty getting my cervix dilated and had to use several instruments before it was dilated enough. I didn't really hurt, but I could feel pressure and an occasional twinge of pain at certain angles.

                  Once that was over, they had difficulty finding my tubes due to my bleeding and the thickness of my uterine lining. They tried for about 15 minutes and almost concluded that they would not be able to complete the procedure today. Then my doctor tried one more thing and we got both the coils in!

                  They cleaned me up (lots of fluid) and I rested in recovery for about an hour with a monitor. I was then released. I was at the office for a total of three hours.

                  The pain had been mostly moderate today...like bad menstrual cramping. I have prescription strength Motrin and Percocet still and have taken two of each so far today and the pain is manageable.

                  Truthfully, other than grogginess from meds and a little cramping, I don't feel too bad! I'll update as I progress through recovery and the test in 90 days! Feel free to ask me any questions!

                  Comment


                  • My Doctor told me prior to the proceedure that it should be scheduled immediately after your period because the cervical tissue is softer and it's easier to dialate. Mine was actually the second week after my period and there was some discomfort. After reading Alexandra5678's post I can see that it definetly helps to do it closer to your period or in her case during. I really wish mine could have been a week sooner. My HSG I didn't schedule around my period and it was actually a week before and I think it would have been easier if I had scheduled it closer. Guess I got a bit excited and didn't think to schedule it then.

                    I started my period after having the HSG test and it was much like my first period after the proceedure. Dark thick discharge like the end of your period with very little pain. Maybe it has something to do with the cervix being opened recently. Who knows but if it continues next month I will probably ask my doctor about it.

                    Also, I came accross a post in the Essure Failure forum that mentioned MAUDE. Apparently the FDA has a program set up that you can search online for devices and such so see the problems and status of reported problems. One thing that I noticed in every single Essure complaint was that a report had not been made to the manufacturer. If anyone has any problems make sure the manufacturers are being made aware so that they can make improvements or have updated statistical in formation. The more input they get the better service they can provide for future patients. If anyone is interested in looking at the MAUDE database here is the link.

                    **Removed outbound link**
                    Last edited by LanaBear; 12-15-2009, 04:18 PM. Reason: Outbound links not permitted.

                    Comment


                    • Conceptus is not making the reports nor are the doctors. Most women don't even know they can make a report. I made my own report and so have some of the women. You can find mine. You can find some patients have reported pregnancys. You will also find that just recently the database states that due to some technical difficulties not all reports are currently available. The report I made months after a malfunction occurred while the essure rep was present and she did not file a report nor did she file a report when I had to have them removed. The doctor made a report after I called him and ask why he hadn't made one. Of course it was almost 5 months later that I made my own report and called the doctor. Another fact that you can find on the FDA website is that the FDA estimates that less than 1% of all adverse events get reported. That is why I post about the maude fda website. I also try and help explain the process. It can be very confusing to some. Bottom line--it is not the patients responsibility to report adverse events. I didn't know until I stumbled across the site and called the FDA that I could make my own report. It is the company and the doctors duty.

                      Comment


                      • Checking in 5 days post-Essure

                        Well, it's been 5 days now and I am doing well. My biggest complaint is nausea from the mandatory BC pills and some constipation (most likely from the pain pills I took for about three days). I'm off all meds now...although I still have a teensy bit of cramping, but it is not bothersome. I still have some odd discharge which my doc says is the last of all the fluid they had to put in me so everything was cleaned out enough for them to see and do the procedure. I am a little freaked out mentally just because of some the the terrible stories about this procedure, but so far I seem to be doing well and not having any complications. I think for anyone considering this, you need to do your research and feel very comfortable with your doctor. Like anything, there are risks and some women have had terrible experiences, but others have had smooth sailing and are glad to have it done. Just make sure you have a balanced approach to researching that includes a combination of medical information and personal stories. I'll keep checking in as I progress through recovery!

                        Comment


                        • Day Eight Update

                          Well, for the most part things are good. I have a tiny bit of twingy pain on my left side that has me a little concerned, but it isn't too bad. The doctor says it is normal only a week post, and I had a little more trauma on that side because that was the tube they couldn't find at first. She told me as long as the pain isn't sharp and I don't have a fever that I shouldn't be concerned. I wanted to chime in today for women considering this procedure to be wary of some of the testimonials on the Essure webiste and take them with a grain of salt. I nearly fell out of the chair laughing reading the ones that say "I only took a Tylenol and then I drove myself home and was able to run three miles later that day!". If your doc says he or she is only going to give you a Tylenol....find another doctor and fast! You need pain meds before during and after and soemthing to relax you like Valium or Halcion before the procedure. And you need someone to drive you and a few days to recover. I'm not saying the it is not a fairly easy procedure, but some of the marketing testimonials make it sound like the equivilent of getting a hair cut! I want to people to know what to expect!

                          Comment


                          • HSG after Essure

                            I've been pretty anxious about getting the HSG done (more so even than the initial procedure), and was glad to have the test completed yesterday.

                            Checked into the radiology department at the hospital and signed a few forms. A radiology tech came out to get me, and allowed my husband to come back for the test, which I appreciated.

                            She took me to a private room (with it's own bathroom and dressing area attached), asked me to completely undress from the waist down, and gave me a gown to put on over my t-shirt.

                            My GYN arrived and instructed me to lay down on my back with my bottom at the very edge of the table. I was asked to bend my knees and pull them towards my chest. He helped me move each leg into stirrups on either side of me that elevated my feet, supported my knees and calves, and flexed my thighs widely apart. He and the tech then draped a sheet over my legs so I didn't feel so exposed.

                            The GYN began by inserting a lubricated speculum into my vagina, and swabbed my cervix with a betadine solution. I was hopeful that he wouldn't have to use a tenaculum to help thread in the catheter, but even though I've had a child, my cervix didn't cooperate very well and the first attempts at inserting the catheter were unsuccessful. He then used the tenaculum to grip my cervix, stabilize it, and then slid the catheter into my uterus and inflated the balloon on the catheter with normal saline.

                            This was the most uncomfortable part of the exam for me (i.e. uterine pressure, moderate cramping). Once the catheter was inserted and the balloon inflated, he removed the tenaculum (which unfortunately had lacerated my cervix). So he used a hemostat and gauze to put pressure on my cervix to slow the bleeding down. He continued with the cervical pressure until the radiologist arrived. Once the radiologist arrived, the GYN removed the gauze and the speculum and covered my pelvic area with the sheet.

                            The radiologist adjusted the table and moved the fluoroscopy machine over my pelvis until it was almost touching my knees. The GYN and the radiologist moved the monitor over by the table so that I could watch the contrast fluid being injected into my uterus. The radiologist took a view of my uterus as the contrast was injected, and then asked me to roll onto my right hip, and then onto my left hip, and then took a final view of my uterus with me on my back. Both he and the GYN agreed that my tubes had occluded, and that the Essure implants had been a success. It feels a little awkward to roll from side to side with your legs in stirrups and a catheter in your cervix, but I managed. The GYN then deflated the balloon, removed the catheter, and I was allowed to use the bathroom and change clothes.

                            After reading some of the experiences people have had with HSG's, I think part of my difficulty resulted from being really afraid of the test. Honestly, it was uncomfortable, mild to moderate pain, but nothing I couldn't handle. The cramping was fairly strong for the first hour after the procedure, but then faded. I bled quite heavily for the first six hours after the procedure (most likely due to the cervical laceration), but it has slowed down some today. The contrast injection and fluoroscopy portion didn't take long (maybe five minutes at most). The total set-up and procedure probably took between 15 and 20 minutes. I had been instructed to take 800 mg of Advil three times a day in the 24 hours leading up the procedure and was given a Vicodin to take one hour prior to the procedure, which I think helped.

                            My advice to anyone having an HSG is to work with a doctor you know and trust. I was very grateful that my GYN was able to be there and helped get everything set up. Talk to your doctor beforehand if you're nervous and ask questions. Having my husband there to hold my hand during the tenaculum placement and catheter insertion also really helped. While it's not something I would want to do every day, it was a short, manageable period of time--and provided me with the reassurance that the Essure procedure had been a success.

                            Best of luck to anyone considering Essure--it was definitely a better option for me than surgery would have been.

                            Comment


                            • Some of the problems women have with the HSG is the amount of pressure used to perform the test. The company is recommending that very little pressure be used so it won't hurt as bad. Mainly because women are getting ****ed about the pain. The normal HSG test they use to check fertility for those who are having trouble getting pregnant is done at high pressure. While not using as much pressure may make it more comfortable for women is it really showing complete tubal occlusion. I have to wonder if thats why pregnancys are occurring after so called sucessful confirmation.

                              Comment

                              Womens Health orange logoGet The Newsletter

                              Receive our passionately crafted, medically reviewed articles and insights — the stuff nobody else talks about but you want to know — delivered right to your inbox.

                              Latest Posts in Our Forums

                              Collapse

                              Latest Topics in Our Forums

                              Collapse

                              Working...
                              X