Hysterectomy Recovery May Be Several Weeks, Even Two Months

So, you’ve had your hysterectomy, everything’s fine now. Sit around the house a couple of weeks and then it’s time to go back to life. It would be nice if it worked that way. For some women who have minimally invasive hysterectomies recovery may follow that scenario somewhat. However, for most women hysterectomy recovery will mean at least a day or so in the hospital followed by several days of limited movement at home. For those who undergo abdominal hysterectomies which may include the removal of other reproductive organs the period of recovery may be several weeks, even two months.

Women who had vaginal hysterectomies or simple laparoscopic hysterectomies will often go home on the first or second day after their operations. Except in the most exceptional circumstances even women who have had extensive hysterectomies will begin limited, supervised movement within the first twenty-hours after surgery. A woman who has had an abdominal hysterectomy that included removal of the ovaries will find herself walking the hospital hallways with someone for support on the second day after her surgery. Make no mistake, this will be painful. Lying in bed without exercise, however, will only make the recovery period last longer and be even more painful.

In the days after her surgery it is very important that a woman not do any lifting or other exercise which would strain her back, upper legs or pelvic area. There should be no sexual activity until the woman has been given a green light by her physician. It is also important to get plenty of rest, eat a healthy diet and drink lots of water.

After going home a woman should be on the look out for indications of possible problems. If she notices any of the warning signals, a woman should report them immediately to her doctor. Things to watch for include: Pain in the back, upper legs, pelvic area; pain when urinating; nausea, vomiting, dizziness; heavy bleeding; redness, swelling; an open incision and/or a leaking incision. In the hours, days and weeks following her hysterectomy a woman may suffer from extreme tiredness, lethargy and depression. She should not be unduly concerned about these symptoms as long as they do not last for more than a week to ten days.

A woman should return to her normal schedule gradually. Her body will be her best guide for what she is able to do. However, she should be mindful that lack of exercise can be as tiring as too much exercise. The longer a woman waits to get back into the swing of things the more difficult it may become to have a complete hysterectomy recovery. Post hysterectomy it is also very important for a woman to have annual physicals at the very least.

Many times women view hysterectomy as a totally negative experience. No doubt there are unpleasant and painful aspects to any hysterectomy. Still, although life after surgery may be different that does not mean it will be diminished. Making sure to have a good hysterectomy recovery is the best first step toward meeting the challenges of post operative life.

Check Out Our Brand New e-Book –> Women’s Hysterectomy Stories – The Essential Guide by: Ruth Steeves. Click Here Now for Instant Access!

Subtotal Hysterectomy Removes Only A Woman’s Uterus Not Her Cervix

A subtotal hysterectomy removes only a woman’s uterus not her cervix. Many women may not even think about the fact that in most cases a woman loses her cervix along with her uterus. While this may not seem vastly important, losing the cervix does have consequences. Therefore, if a woman’s medical condition does not dictate the removal of the cervix, she may want to consider a subtotal hysterectomy.

The cervix is the inch or so long piece of connective tissue which forms the neck of the uterus; it is essentially the protective opening between the vagina and the uterus. Any time a woman chooses to have a vaginal hysterectomy she automatically chooses to have her cervix removed. When the cervix is removed two things may happen: One, the vaginal area may become significantly dryer; two, since the cervical tissue supports many of the pelvic ligaments, the pelvic area may become less stable. After considering these side effects, a woman may want to discuss the possibility of a subtotal hysterectomy with her doctor. A woman considering a subtotal hysterectomy needs to know that since her cervix will remain she remains vulnerable to cervical cancer. Thus, it is imperative that she have pap smears on a schedule prescribed by her gynecologist.

If a woman and her physician decide that a subtotal hysterectomy is appropriate there are generally two methods by which it may be accomplished: An abdominal hysterectomy and the tongue twisting laparoscopic supracervical hysterectomy. An abdominal hysterectomy generally requires additional time in surgery, a longer hospital stay and a longer post operative recovery period. It also leaves a large scar, although the scar can sometimes be lessened by an artful surgeon. For this reason many women consider the laparoscopic subtotal hysterectomy procedure.

A subtotal hysterectomy assisted by a laparoscope (slender optical tube) begins with a small incision below the patient’s navel through which the instrument is inserted. After the surgeon has located and examined the uterus two more small cuts will be made through which additional surgical instruments will be inserted. These tools will be used to cut the uterus, but not the cervix, away from the body. The organ will then be cut into strips small enough to be removed through the previous incisions. Scarring will be limited to the three small cuts made for inserting the needed instruments. Performed in this manner a subtotal hysterectomy requires only slightly more time in surgery than a vaginal hysterectomy. The hospital stay and recuperation time will also be somewhat longer.

A laparoscopic supracervical hysterectomy can only be used in circumstances where the uterus has not been substantially enlarged by disease. If due to an ailment the uterus has grown too large to be removed via the laparoscopic method an abdominal hysterectomy will be required. The possibility of a laparoscopic subtotal hysterectomy turning into an abdominal hysterectomy should be fully discussed with the surgeon prior to the operation.

Loss of the cervix as part of a total hysterectomy may not be of immediate concern to some women. In addition, many women may not want to have an abdominal procedure in order to retain the cervix. However, any time it is medically possible to save a piece of healthy tissue, it should be a matter for consideration. A woman who feels that she would be best served by having her cervix in place should be aware of the subtotal hysterectomy alternative.

Check Out Our Brand New e-Book –> Women’s Hysterectomy Stories – The Essential Guide by: Ruth Steeves. Click Here Now for Instant Access!

Total Abdominal Hysterectomy hysterectomy procedures

Total abdominal hysterectomy is the most common of the hysterectomy procedures. It involves removing the uterus and the cervix through an incision in the abdomen. While the reasons for having a total abdominal hysterectomy may be compelling, if there is not diagnosis of malignancy a woman may want to consider options short of this procedure.

There are many circumstances under which a doctor might prescribe a total abdominal hysterectomy; certainly the most severe situation would be cervical or uterine cancer. If cancer is diagnosed unless a woman mistrusts the diagnosis, a total abdominal hysterectomy is the only option. If a woman wants a second opinion on the doctor’s finding she should proceed with all speed; cancer of the reproductive organs can spread quickly. As a result delaying treatment could cause the need to remove other organs or could cause the condition to become incurable.

Many times, though, a total abdominal hysterectomy may be used to correct less severe maladies such as large fibroid tumors, chronic endometriosis or continued heavy bleeding. At some point a total abdominal hysterectomy may become necessary to alleviate these problems; however, before that time arrives a woman may want to consider less invasive procedures such as endometrial ablation and/or hormone therapy. Once it has become evident that lesser therapies are not the solutions, a woman may still want to contemplate having a hysterectomy in which her cervix is preserved. A procedure of this sort is referred to as a subtotal hysterectomy or a supracervical hysterectomy.

If a woman opts to have a total abdominal hysterectomy she should be prepared for surgery lasting one to two hours followed by a hospital stay of two to four days. The amount of abdominal scarring will depend upon the size of the uterus when it was removed. Often a doctor can make a horizontal “bikini line” incision that is less visible and more easily disguised. Women should realize that the extent of scarring often depends on individual skin types.

Some women feel that the loss of the uterus dampens their sexual desire and/or sexual response. Additionally, if a woman’s cervix was removed along with her uterus she may notice that her vagina will be significantly dryer. Since the ovaries are not removed as part of a total abdominal hysterectomy, menopause should not begin. However, diminished blood flow to the ovaries or subsequent ovarian failure may cause the onset of menopause at a later date. There are treatments available for any ailments which may result from hysterectomy. Do not be embarrassed to ask your doctor about these therapies. Lower back pain, pelvic pain, pain in the upper thighs and/or painful urination should all be reported to the doctor; as should nausea, dizziness, fever, swelling and/or unusual bleeding or leakage.

Once released to go home recovery from an abdominal procedure will take from three to six or perhaps even eight weeks. During this time the woman should refrain from driving, strenuous activity and sexual activity. She should also get plenty of sleep, eat a healthy diet and drink plenty of water. After receiving her physician’s approval a woman should be able to gradually return to her normal routine.

Check Out Our Brand New e-Book –> Women’s Hysterectomy Stories – The Essential Guide by: Ruth Steeves. Click Here Now for Instant Access!

Complete Hysterectomy Not The Same as a Total Hysterectomy

A complete hysterectomy is not the same procedure as a total hysterectomy, although many people use the terms interchangeably. The uterus, cervix, ovaries and fallopian tubes are removed during a complete hysterectomy. Only the uterus and the cervix are taken out in a total hysterectomy. When speaking with her doctor a woman should take care that they are using the same terms when discussing potential surgery.

Most women face the challenge of a complete hysterectomy in response to a severe diagnosis. Cervical cancer and ovarian cancer are two of the diseases for which a complete hysterectomy may be prescribed. However, large uterine and/or ovarian fibroid tumors may also necessitate the procedure. A complete hysterectomy might also be required in cases of chronic endometriosis which has migrated to other organs or which has caused adhesions. Because a complete hysterectomy causes the immediate onset of surgical menopause, it is important that a woman be fully aware of the side effects which will ensue. In circumstances where a malignancy may be involved there is generally no other medically accepted option other than a complete hysterectomy. In fact, the operation should probably be pursued with alacrity since untreated cancer of the reproductive organs can spread quickly.

A woman who has been fully informed about what to expect after a complete hysterectomy will find that her post operative recovery period will proceed much more quickly. She will also be able to decide prior to her operation what cause of therapy she may want to pursue after her operation. Therefore, a woman should not be afraid of taking the initiative to do personal research about the complete hysterectomy procedure. In addition, she should also not shy aware from asking her doctor any and all questions which she may have.

Any hysterectomy ends a woman’s ability to bear a child. After a complete hysterectomy a woman will begin to experience the symptoms associated with menopause: Hot flashes, night sweats, vaginal dryness, decreased sexual response and/or sexual desire. A menopausal woman may also become depressed and she is at greater risk for developing osteoporosis. When menopause occurs suddenly due to a complete hysterectomy these symptoms may hit a woman with greater ferocity.

While these indications are certainly distressing they should not prevent a woman from having an operation which she and her doctor have decided must be done. All women eventually face menopause and there are treatments which can lessen the problems it creates. The symptoms of menopause also fade with time. After a complete hysterectomy a woman may want to consider hormone replacement therapy (HRT). In recent years, however, HRT has come under increasing fire for having risks that outweigh its benefits. For that reason a woman may want to discuss other approaches to relieving any signs of menopause. Alternative therapies include vitamins, herbs, exercise and changes in diet. Meditation and aromatherapy are also helpful for many women.

Undergoing a complete hysterectomy will change a woman’s life. If the condition for which it is being considered is not life threatening a woman may want to consider trying other, less invasive treatments first. Still, the maladies brought on by a complete hysterectomy can be treated. A woman who needs a complete hysterectomy should not allow fear of menopause alone dissuade her.

Check Out Our Brand New e-Book –> Women’s Hysterectomy Stories – The Essential Guide by: Ruth Steeves. Click Here Now for Instant Access!

Laparoscopic Supracervical Hysterectomy

The Laparoscopic Supracervical Hysterectomy is a procedure many women choose to have when deciding to have a hysterectomy. The procedure is one many find is less invasive then the other choices for a hysterectomy.Some doctors refer to the laparoscopic supracervical hysterectomy as the pain-less hysterectomy.

The supracervical laparoscopic hysterectomy is a procedure where tissue is removed from the body through a tiny incision of about 14 mm. The procedure doesn’t require the surgeon to suture and with no stitches required, the healing process for the patient is often easier. Patients seldom need pain medication after the laparoscopic supracervical hysterectomy because the procedure is so simple.

Doctors find the procedure for this hysterectomy easier to perform and often recommend it above any other hysterectomy for the patient.LSH is used to identify the Laparoscopic Supracervical Hysterectomy. The LSH procedure doesn’t require the woman to lose her cervix which seems to be a major concern for many women who need to have a hysterectomy. Naturally, the LSH is not a procedure women with a family history of cervical cancer will consider. There are several advantages to the LSH procedure. These are:

• Shorter hospital stays • Much shorter time in the operating room for the patient • Few side effects or complications during or after the surgery • Same day surgery is often possible • Pain medication is seldom used

Patients who have the LSH procedure normally have discovered their need for a hysterectomy because of ongoing medical problems. The patient may need the LSH because of heavy monthly menstrual periods, ovarian cysts which have become problematic, pain in the pelvic region, endometriosis or fibroids. Thereare a few other medical problems which can be treated through the LSH procedure. If doctors believe they can perform the LSH procedure and cure the problems of the patient, they will try the LSH procedure in lieu ofthe abdominal hysterectomy.

Patients would rather have the LSH procedure rather thanthe abdominal hysterectomy and prefer the recovery time to any other vaginal or abdominal hysterectomy.Women who are considering a hysterectomy should ask their doctor about the Laparoscopic Supracervical hysterectomy. The recovery is almost non-existent and patients can be back to work in a short time. Ask your doctor for an information brochure on the LSH and see if you qualify for the procedure. Not all hysterectomies can be performed this way but if you are a candidate, then this is the best choice for you if you want pain-free and this hysterectomy is as close to pain free as it gets!

Check Out Our Brand New e-Book –> Women’s Hysterectomy Stories – The Essential Guide by: Ruth Steeves. Click Here Now for Instant Access!

Pregnancy after a Partial Hysterectomy

What to ask Your Doctor about Pregnancy after a Partial Hysterectomy

If you want to become pregnant and are scheduled to have a hysterectomy then you should certainly talk to your doctor about your options. You will likely hear all sorts of stories about women who were still able to have a baby after a partial hysterectomy but you should talk to your doctor about his or her opinion and medical facts.

A partial hysterectomy is a hysterectomy where becoming pregnant after the procedure is still possible according to some documentation supporting this. However, in all likelihood, other options will have to suffice. Options for having a child should now include finding a surrogate or an adoption. Depending on your financial situation, either of these options should work for you if you truly want to be a parent.

Before your hysterectomy, talk to your doctor and ask him or her the following:

• What are my chances for becoming pregnant after a hysterectomy?
• Which hysterectomy should I have if I want to be left with some possibility for a later pregnancy?
• What are those chances for each procedure?
• Is there any way to become pregnant now and postpone the procedure and if so, what complications do I face?

Talk openly and honest with your doctor and ask her what she recommends for you. If you know child bearing is of importance to you, see if you can realistically postpone the surgery for a hysterectomy. If you are having a hysterectomy because of heavy bleeding, then it’s likely you can try to become pregnant before the procedure.

Pregnancy isn’t something you should take lightly and neither is a hysterectomy. It is possible to become pregnant after a partial hysterectomy but honestly, you should talk to your doctor about whether or not it is likely. In all probability, it will limit your chances of a pregnancy.

Check Out Our Brand New e-Book –> Women’s Hysterectomy Stories – The Essential Guide by: Ruth Steeves. Click Here Now for Instant Access!

What is a Radical Hysterectomy?

A radical hysterectomy is a hysterectomy which a woman usually is offered as a hysterectomy option when they are told they have cervical cancer. The hysterectomy for cervical cancer is called radical. This varies from other hysterectomies because a woman must undergo the removal of the upper third of her vagina as well as most of the tissue around the cervix.

Cervical cancer is a leading cause of women’s cancer and health issues. A radical hysterectomy can be a scary time for a woman and most women do not understand the differences between the radical hysterectomy and the other options they have. Still, the radical hysterectomy is the best choice for a woman who has cervical cancer and the hysterectomy will be followed by radiation or chemotherapy.

During a hysterectomy, the biggest problem a patient will face can be blood clots. Clotting in the legs or pelvis can lead to blood clots in the lungs. Radical hysterectomies are handled with care and patients can talk to their doctor about prevention of these clots and some exercises which can minimize the chances for clots.

Hormone Replacement Therapy or HRT is something you will need to become accustomed to after your surgery in some cases. Look at it as the lifelong birth control pill because that is basically what hormone pills are. You will be able to find a pill right for you and you shouldn’t worry too much about having to take hormones because this is normal after a hysterectomy.

A radical hysterectomy is scary and you will not be able to bounce back as quickly as you might hope but there is hope with this procedure after a diagnosis of cervical cancer. You just have to look for it and remain positive. There is a high success rate with the radical hysterectomy for cervical cancer if the cancer is caught in time.

Check Out Our Brand New e-Book –> Women’s Hysterectomy Stories – The Essential Guide by: Ruth Steeves. Click Here Now for Instant Access!

Supracervical Hysterectomy Allows A Woman To Keep Her Cervix Intact

Supracervical hysterectomy allows a woman to keep her cervix intact when the decision has been made to remove her uterus. Many women may not think about the fact that a vaginal hysterectomy takes the cervix out at the same time that the uterus is removed. Even if they do think about it most women won’t be aware of the reasons they may want to preserve this piece of connective tissue.

What is the cervix and what purpose does it serve?

The cervix links the uterus to the vagina. It is about an inch long and can be felt by inserting a finger into the vaginal canal. The cervix performs two functions: One, it helps to lubricate the vaginal area; two, it provides support for a wide variety of pelvic ligaments.

Why would a woman want to avoid having her cervix removed?

Any time the loss of a useful piece of body tissue can be avoided, it should be avoided. While a woman can get along without a cervix she may notice significantly dryer vaginal tissue after its loss. Losing her cervix may also destabilize the pelvic area. For these reasons if there is no evidence of cervical disease, a woman may want to discuss a supracervical hysterectomy with her physician.

How is a supracervical hysterectomy performed?

A supracervical hysterectomy proceeds through the abdomen. An incision is made, the uterus is cut away from the body and the cervix is not. While the operation may sound simple, it is not. Any form of hysterectomy is major surgery. An abdominal hysterectomy requires more time in the operating room, a slightly longer hospital stay and a somewhat longer rehabilitation period. It will also leave abdominal scars; for these reasons many women may avoid having an abdominal hysterectomy. In fact, the possibility of operating through the abdomen in order to save the cervix may never even be discussed with a woman if she simply asks her doctor about the easiest way to remove her uterus.

A laparoscopic supracervical hysterectomy is an alternative which a woman may want to consider. The doctor utilizes a laparoscope (a thin optical tube) inserted through a small abdominal incision to view the pelvic cavity. The surgeon will then insert other slender surgical instruments through two additional small cuts. These instruments will be used to cut the uterus, but not the cervix, from the body and to shred it into pieces small enough to be pulled out through the incisions. The time in surgery, the time in the hospital and the recovery time are all only slightly longer than those required by a vaginal hysterectomy. Scarring is limited to the sites of the three incisions.

After research and consultation with her doctor, a woman may decide that keeping her cervix is the appropriate course of action in her particular circumstance; if so, she will elect to have some sort of supracervical hysterectomy. Any woman who chooses this route should be aware that by not removing her cervix she remains vulnerable to cervical cancer. It is, therefore, of prime importance that she continues to have regular pap smears.

Check Out Our Brand New e-Book –> Women’s Hysterectomy Stories – The Essential Guide by: Ruth Steeves. Click Here Now for Instant Access!

Radical Hysterectomy Most Extreme Forms Of The Procedure

As implied by the term, a radical hysterectomy is one of the most extreme forms of the procedure. Most often prescribed for cancer of the cervix it may sometimes be used in cases of ovarian cancer. While a severe operation requiring substantial rehabilitation, a woman facing radical hysterectomy should know that a full recovery and return to lifestyle are the rules not the exceptions.

A radical hysterectomy involves the removal of the uterus, cervix, ovaries, fallopian tubes and a portion of the upper vagina. The tissue around the cervix and the pelvic lymph glands will also be excised. Depending upon the specific situation, chemotherapy or radiation therapy may also be suggested. The surgery will take several hours and a hospital stay of seven to fourteen days will be required. Recovery may last up to three months.

For the two days immediately following her surgery a woman will most likely be heavily sedated. She may also have pelvic drains and a catheter; these devices are temporary and there only to reduce the possibility of infection and to make it possible for her to have full bed rest. It is normal for there to be light vaginal bleeding or spotting. During this time the woman will begin gentle exercise under the direction of a nurse or physical therapist. To lessen the possibility of a blood clot it is important to begin supervised movement, followed by getting out of bed and walking as soon as prudent after a radical hysterectomy.

Upon arriving home the woman should refrain from any lifting or strenuous exercise during the recovery period. In most cases a woman will be able to return to normal activity in two to three months. Do not undertake activities such as driving, swimming or exercise classes until the doctor has specifically advised that such movement is acceptable; the same is true of sexual activity.

Numbness of the pelvic area as well as in the thighs and upper legs may occur post operatively. These problems should fade with time. It is imperative that the woman’s doctor be kept informed of any symptom which increases in severity or continues beyond a reasonable amount of time.

Removal of the ovaries will cause the sudden onset of menopause. The symptoms associated with this change of life (hot flashes, night sweats, fatigue) may be more severe for a woman who enters it in such an abrupt manner. Additionally, the loss of the uterus and cervix may result in decreased sexual desire and/or response as well as vaginal dryness. Depression may also be acute. Many of these indications can be alleviated through a regimen of hormone replacement therapy (HRT) or other medications and/or natural remedies. After the recovery a return to exercise and an attention to diet will also help with any residual problems.

When a woman receives a diagnosis of cervical cancer and is told that she should undergo a radical hysterectomy, she may be understandably shaken to her core. It is important that she seek and receive support and understanding. There are many support groups for women in this circumstance and a woman need not wait until after her operation to begin attending one. If she is reluctant to visit a support group in person, a woman may want to consider finding one online. By discussing her diagnosis with other women who have battled the same opponent, a woman will realize that she is not alone and that a long full life is possible after a radical hysterectomy.

Check Out Our Brand New e-Book –> Women’s Hysterectomy Stories – The Essential Guide by: Ruth Steeves. Click Here Now for Instant Access!

Hysterectomy Hormone Replacement Therapy

For many years prescribing hormone replacement therapy (HRT) after a hysterectomy was almost automatic. Not only were HRT prescriptions widely written, they were accepted almost without question by the patients to whom they were given. However, in the last decade many women and their doctors have begun to question the near universal use of post hysterectomy hormone replacement therapy. As questions continue to arise on both sides of the issue it is important for women who have had or will be having hysterectomies to make sure they are well informed about HRT.

Just exactly what is hormone replacement therapy?

HRT can consist of either an estrogen/progestin combination or the hormones taken individually. Estrogen is a female hormone. Progestin is a synthetic version of the female hormone progesterone. Hormone replacement therapy may be administered orally, via a skin patch or as a cream. It is used not only after a hysterectomy but may also be suggested for women who are suffering severe symptoms of natural menopause.

Why was hormone replacement therapy routinely prescribed for women who had undergone hysterectomies?

If a woman has a hysterectomy in which both of ovaries are removed she will immediately be thrown into surgically induced menopause. For some women, this sudden onset of menopause will feature symptoms more severe than those experienced during natural menopause. Women who are left with at least one ovary may not find themselves menopausal until near the normal time when menopause would have occurred. There may, however, be some menopausal symptoms due to diminished blood flow to the ovary or due to ovarian failure at a later date. Women who have only their uteruses or uteruses and cervixes removed will generally not experience any symptoms of menopause post hysterectomy; however they may suffer from vaginal dryness and/or reduced sexual desire and/or reduced sexual response. Since many of these post hysterectomy indications are thought to be alleviated by HRT it became a standard post operative prescription. In addition to addressing hysterectomy induced menopausal maladies there was also some thought that hormone replacement therapy protected women from illnesses such as osteoporosis and heart disease.

Why has hormone replacement therapy come under question?

Over the last fifteen years many have come to believe that the risks related to HRT outweigh the benefits. Diminished vulnerability to osteoporosis is still viewed as the main advantage to hormone replacement therapy although this benefit appears to decrease as a woman ages. HRT may also be valuable in helping women deal with menopausal depression; here again though there are other therapies which may be more effective. While hormone replacement therapy may precipitate a decline in so called “bad” cholesterol, the increased risks of heart attack and stroke which emanate from HRT are greater than the benefit of the reduction in “bad” cholesterol. There is also a marked increase in several cancers particularly breast cancer amongst women who used hormone replacement therapy.

The unexpected medical findings concerning HRT caused many ongoing hormone replacement therapy studies to be halted prior to their completions. There was fear that the women involved in the studies were being subjected to unnecessary risks. As a result, many doctors chose to stop prescribing HRT as a matter of course. Women also became reluctant to use estrogen and progesterone as their primary methods for relief of post hysterectomy menopause symptoms.

Despite the fact that hormone replace therapy is now under intense scrutiny there are individual cases where its advantages may preclude its disadvantages. A woman facing hysterectomy should not reject or accept HRT out of hand; rather she should make a well researched and considered decision in consultation with her doctor. As with most important medical decisions, the choice to take hormone replacement therapy should be based on the specific circumstances of the woman involved.

Check Out Our Brand New e-Book –> Women’s Hysterectomy Stories – The Essential Guide by: Ruth Steeves. Click Here Now for Instant Access!

« Previous Page — Next Page »