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Old 10-04-2008, 07:15 AM   #1
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Exclamation Diagnosis of Pinched Nerve in Cervical Spine without MRI or xrays

I would like to keep this post brief if possible: So I will do it in Stages from the Beginning:
1. During the first week in Sept. this yr. 2008 (around Sept. 8) I became overcome with debilitating pain in my right shoulder, under the right shoulder blade and down my right arm with a tingling sensation through my fingers. It started with muscle spasms and severe pain. I can actually see the spasms on the top of the arm.
2. I went to a medical professional on 9-12 (not a doctor but an NP) who diagnosed me with muscle strain (trapezoid muscle). I was in so much pain. My Blood pressure (no history of high blood pressure ever) was 170 over 101 that day which she attributed to PAIN. I was sent home without examination with Flexaril and Oxycodone which gave me no relief.
3. 17 days later on Sept. 29 after suffering with this pain on the right side of my upper neck and shoulder,and right arm I was seen by an ER doctor who gave a preliminary diagnosis of cervical radiculitis (pinched nerve) again with no xray but diagnosis made solely on my symptoms. Note: My blood pressure when checked into the ER was 201 over 105 with a pulse of 92. I was given three shots, dilaudid, phenergran, and a form of steriod. I was sent home with Hydrocodone, Methacarbomol, and a Medrol dose pack (Steroid). None of this has even touched this pain only taken the edge off a very small amount. Since this time the pain has been so severe I have even seen a psychiatrist to see if I was losing my mind with pain or simply withdrawal from a seventeen year use of clonazepam and was prescribed clonazepam again for anxiety (I was on this previously but my RX had run out on Sept. 12 after this pain began in my right arm and shoulder so there seems to be no relation, only re-introducing the clonazepam did help with the unbearable anxiety caused by the pain.
4. The ER Doctor recommended that I go to a Pain Management Clinic (I have been on Pain Killers since September 12th, 2008. Without doing any tests, xrays, MRI's or any other examination how can a doctor diagnose you with a pinched nerve based solely on symptoms alone? Note: Is a Pain Management Clinic where I should start even though I am in so much pain it even hurts to breathe? Or is there someone else I should see first? The only relief I have is minimal through the use of hydrocodone and a muscle relaxer. When the pain is greatest my muscles just on the right shoulder area and arm spasm so badly I cannot even judge my pain because it goes beyond the scale of a ten, with ten being the highest.
5. Today is Saturday and I am loaded with pain killers, muscle relaxers and more but I see no relief for that until someone helps me.
6. My real question here is do I go to a Pain Management Clinic for help first without a true diagnosis or do something different. I am in so much pain it is difficult to make a decision on what to do next.
Please, Please, someone help me. After nearly a month now I cannot tolerate this pain any longer. It prevents me from doing anything, including working(I do computer work 85% of the time and now can only do that for a minimum of 15 to twenty minutes at the time without intense pain so I have to keep taking too many breaks to complete any project at all. To add to this I cannot even sleep or rest because of the pain even on pain killers.
If there are any real Doctors on this site that can just steer me in a better direction or a more appropriate direction on this I do not need to know your name or who you are I just need help quickly. I have not had a normal day in many weeks. I must also say that I do not have health insurance at this time and I have run into some serious barriers here because of it but I do have an old 401K which was supposed to be my retirement but I am willing to spend it all to feel better. Many doctors will not even see you without Health Insurance but since when did cash not spend? I want and need help so desperately that I will do anything.
Sorry this is so long but I am desperate and I need help. I cannot work like this (cannot perform any normal duties) and it makes it impossible to find a job while I am in this condition. (I was laid off from my job on May 23, of this year but I did not have health insurance benefits anyway.)
Help Me Please Someone!

 
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Old 10-04-2008, 09:39 AM   #2
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Re: Diagnosis of Pinched Nerve in Cervical Spine without MRI or xrays

honestly,you simply NEED that MRI done asap. something is very obviously wrong here that NEEDS to be identified and treated APPROPRATELY for whatever is causing such over the top pain in there. i really do feel for you and how you are being treated. i seriously would seek out another primary doc who WILL give a rats butt about your suffering. this has gone on wayyy too long already without even an MRI to go on to really SEE what is actually going on in your c spine?? i am willing to bet that is where the underlying problem lies just given your radiculopathic types of symptoms.

if you actually go to a PM doc,i would say that they would want to get that MRI asap just so they really know what it is they are trying to treat. that part has not yet even been done,an actual Dx of your ongoing symptoms. this could be an actual surgical situation that wont get better until whatever is compromising nerves in there just gets relieved,you know what i mean? this is really sick in the way you have NOT been treated,really sick. i do think just obtaining that one MRI,preferably with a contrast agent,would show exactly what the real problem is up there. i am kind of suprised that even the ER wouldn't at the very least have done simple x rays on you either. whats up with the overall healthcare where you live???

i would simply demand that MRI be done at this point. it should have been done at the very beginnig when you had to go back to your doc the second time,ya know? you just have every indication of nerve root compression or something that is very much affecting the nerves up in your c spine. it doesn't take a rocket scientist to figure out that much,ya know? i would simply tell your doc that this has gone on long enough without an actual Dx of the cause and tell the idiot that you NEED and want an MRI done now. you are simply tired of the ongoing suffering and the overall effects this 'unknown' condition is having on your life. it just needs to be done and like i said,it SHOULD have been done long ago on you just to ID the actual problem. to keep denying you the one in depth test that would most likely have shown whats up in there a very long time ago is just so sick,really.

you need to start really advocating for yourself at this point since no one on your healthcare team appears to be doing it for you or even seems to care what is actually causing this ongoing hell you have been living in. sometimes we just have to take control for our own health and sometimes we have to get demanding. in your case,i would just be so dang angry at this point i would TELL your doc to refer you for that MRI NOW. if for some sick reason they wont even do that for you,seek out another more caring doc. this is just pathetic. that one simple test would just show what is going on up there,and thats the key. a Dx of what is causing all this. this is pretty involved just given what you have stated as ongoing symptoms and someone should have just sent you for the MRI by now to find the cause. pretty simple for them to do ya know?

i would make an appt with your primary and lay it all out on the line for them. you simply NEED to know the source and casue of your symptoms with an MRI,period. this is almost a negligence type of situation,geez. get a clue doc?? i do hope they will finally see the actual need for the MRI and just do the right thing here for you. please let me know what happens,K? if you have to get demanding,then do it. you just really have to know at this point what is going on in that c spine. i wish you all the luck in the world with that doc. please keep me posted. marcia
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Old 10-04-2008, 01:10 PM   #3
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Re: Diagnosis of Pinched Nerve in Cervical Spine without MRI or xrays

Thank you feelbad. Unfortunately the doctors in this area are not the compassionate and caring kind (Jacksonville, North Carolina) and the hospital here is even worse. I cannot even get an appointment with my primary Doctor again until October 9th period and the urgent cares here will not treat you without money up front. I really do not know if I can make it until then as my pain medicine will be out by Sunday(tomorrow)(vicodan) and I do not believe I will be able to manage my pain on just over the counter drugs. In fact most people that I know believe this pain is imaginary and if it were I would not be beating my brains out to try and find the answers. A pain management doctor wants $496.00 cash (I have no health insurance) on Monday just for an eval, physical exam and meeting with a nurse. This does not include any xrays or an MRI or any other tests for that matter. If I could just find a compassionate primary care doctor who gives a pardon me about what I am going through but I have exhausted every avenue here and in the surrounding areas. Short of calling 911 I am at a stalemate here and if I did go to the local hospital Onslow Memorial Hospital in Jacksonville, North Carolina, they would just load me up with Morphine and send me away without admitting me to find out the problem. I am not by any means feeling sorry for myself, I am just in astronomical pain where the medication just barely takes the edge off of it. I know that I am being treated inhumanely because I do not have health insurance but I did not do that to myself. I simply was laid off from my job and the HI benefits I did have prior to this were under Cobra. What is a person supposed to do? I am at my wit's end here. I do thank you for at least understanding my position and the lack of genuine healthcare in this are but truly money is all they care about, and not my physical well-being. My whole life depends on finding out the problem and a solution because like I am right now I cannot even function enough to even get a new job much less perform in one as would be expected of me. I am not depressed but I am so very frustrated and I am clueless as to what next step I should take. I cannot even measure the pain I am in. All the vicodan does is take the edge off but never fully relieves it. It keeps me awake and if I do manage a wink or two it WAKES me up.
This pain is cruel!!!!!!!

Last edited by Mod08; 10-04-2008 at 04:44 PM. Reason: No need to copy the quote - address response directly to the individual.

 
Old 10-04-2008, 02:58 PM   #4
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Pain From a Pinched Nerve in The Cervical Spine(Clarification to and Earlier Post)

In a post just a brief while ago I indicated that no one believes that I am in the excruciating pain that I am in. I want to clarify that statement by saying that it was meant to include only the doctors, PAs, NPs and emergency personnel with whom I have been dealing with since my pain started weeks ago. My family, namely my immediate family, my Sisters do know and believe I am in pain. They have tried everything possible to assist me during my effort to find some help and relief. They have driven me everywhere, doctors, pharmacies, the ER and done countless other things and they are as equally frustrated as I am.

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Last edited by HBMod07; 10-04-2008 at 04:13 PM. Reason: Inappropriate comment

 
Old 10-04-2008, 04:22 PM   #5
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Re: Diagnosis of Pinched Nerve in Cervical Spine without MRI or xrays

I totally relate to you. Back in late '02 I had the same problem with the pain. The doctor thought it was a shoulder problem and did emergency surgery only to find that to not be the problem. We figured it out weeks later it could be from my neck.

I had an MRI and it showed that my spinal cord was being compressed, and severely I may add, from several large herniations. I had my neck fused and the pain immediately went away. I was amazed.

I am sorry to hear how you are being treated. My son is going through something pretty similiar and it isn't fair I agree. You need to be assertive and push this because leaving it unproperly diagnosed could lead to long term problems. I don't want to scare you but my surgeon told me mine was so bad from the time I had the MRI to when I had the surgery that had I waited much longer I would have been paralyzed.

The disks affected were C4 to C7. Again I did fantastic afterwards it was like a miracle was performed. The pain prior was something I wouldn't wish on an enemy. Child birth was less painful! It was 24/7 and like you nothing relieved it. It even hurt to use the restroom as weird as it sounds. I literally suffered. I would take a pill, put heating pad on shoulder, not knowing it was my neck of course, lay on the sofa and drift off to sleep an hour later. I'd wake up about 3 hours later and repeat the process. This went on for several months.

If you continue to be treated inappropriately, call someone in your area who works for congress and complain. I don't know what it will do but don't let this slip by. Be assertive. Call the local TV if you have to. Pain like yours, symptoms like yours, demand to be diagnostically tested with an MRI. It sounds exactly like I went through!

Please keep us updated. You'll be in my thoughts.
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Old 10-06-2008, 08:35 AM   #6
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Re: Pain From a Pinched Nerve in The Cervical Spine(Clarification to and Earlier Post

I would see about having some one drive you to Raleigh to a Duke affiliated hospital since it is a teaching hospital. You really do need to ahve a MRI or CT scan to find out what is wrong as you can be causing SERIOUS damage if left untreated. I am surprised that at first they gave you schedule 2 narcotics and muscle relaxer ( flexeril) and sent you home/

 
Old 10-08-2008, 09:32 AM   #7
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Re: Pain From a Pinched Nerve in The Cervical Spine(Clarification to and Earlier Post

Quote:
Originally Posted by lifeaftr40 View Post
I would see about having some one drive you to Raleigh to a Duke affiliated hospital since it is a teaching hospital. You really do need to ahve a MRI or CT scan to find out what is wrong as you can be causing SERIOUS damage if left untreated. I am surprised that at first they gave you schedule 2 narcotics and muscle relaxer ( flexeril) and sent you home/
Thank you lifeafter40. I felt it strange as well but I have the proof to back it up including the receipt from the Dr.'s office and the prescription bottles and receipts. By the way I could not tolerate the flexeril at all as it made my head spin so badly so I just tried to make it on the pain meds plus fill in with Alieve. NP did not even recommend cold packs or heat.

After much suffering and going to one doctor after another I finally had the MRI yesterday Oct. 7. I so totally had to humble myself to get this done as I have been on pain meds for such a long time now. The severity of the pain running down my right arm and the tingling sensation in my fingers or my right hand has intensified even since I had the MRI last evening at 6:00 PM. I have no word yet on the results and I am not sure how long it actually takes but does anyone out there have any idea when I should be able to find out something. I am terrified that I am becoming paralyzed in my right arm and hand and need more pain meds than ever just to give me minimal relief. I have been on this medication so long now it really terrifies me. I am so thankful for all the posts on this health board as those of you who have responded made me figuratively speaking pounce on the doctors and medical people involved to find the problem. The only professional who has cared enough to assist me is my chiropractor, Dr. Hal Crites of Health Source in Swansboro, North Carolina. He has been absolutely wonderful through this ordeal even calling every day to check on me and my progress. He has been so supportive and caring and believe me as busy as he is a professional with a huge practice he has been just extraordinary in his concern for me and my well-being. I had no idea that professionals like him even existed anymore. What a relief it is to know that there is at least one Doctor like him. Believe me this is no infomercial but if and when I ever get better I will be wirting a letter to the newspapers or wherever to commend him for his efforts. Thank all of you who have responded and I will post any new info including MRI results as soon as I receive them. All of you are such a wonderful support group. MarySue57 in North Carolina

Last edited by Marysue57; 10-08-2008 at 09:38 AM. Reason: Needed to add Info on Flexeril and being sent home with no further instructions nor a follow-up appointment

 
Old 10-08-2008, 10:36 AM   #8
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Re: Diagnosis of Pinched Nerve in Cervical Spine without MRI or xrays

I would think that any GOOD pain management doctor would not treat you without first having a definitive diagnosis which can only be reached by getting an MRI.

My story was similar to yours. I woke up one morning years ago with pain - I knew it was a "pinched nerve" as I had something similar in the past. But after my primary care gave me percocet and the pain didn't go away I knew I was in trouble. I switched primary care doctors -on the recommendation of my husband's ENT when my husband had his tonsils out around the same time. The ENT could tell I was in pain and when I described it he said I needed a good primary care doc who would get me where I needed to go. He called and set up my PCP appointment.

Given my symptoms and the duration of the symptoms my new PCP sent me for an MRI immediately along with xrays. Once the results came back he said I had a disc impinging the nerve and sent me to a neurosurgeon. He then recommended epidural steroid injections (ESI) for symptom relief. I did a series of 3 and the pain went away for nearly 2 years.

When the pain came back my PCP then suggested an Orthopedic Spine Surgeon he thought was a better choice. I saw the OSS and he said given that a second round of ESI had not helped (had those done while waiting for the OSS appointment) that in order to alleviate the symptoms and limit permanent nerve damage he recommended surgery. That worked well and we did another surgery this year to further alleviate nerve impingement.

I'm not saying you are headed for surgery - but an MRI can get you to the right diagnosis, the right type of doctor (NS or OSS) and the right treatment.
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Last edited by SpineAZ; 10-08-2008 at 10:37 AM.

 
Old 03-16-2010, 04:18 PM   #9
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Re: Diagnosis of Pinched Nerve in Cervical Spine without MRI or xrays

Quote:
Originally Posted by Marysue57 View Post
I would like to keep this post brief if possible: So I will do it in Stages from the Beginning:
1. During the first week in Sept. this yr. 2008 (around Sept. 8) I became overcome with debilitating pain in my right shoulder, under the right shoulder blade and down my right arm with a tingling sensation through my fingers. It started with muscle spasms and severe pain. I can actually see the spasms on the top of the arm.
2. I went to a medical professional on 9-12 (not a doctor but an NP) who diagnosed me with muscle strain (trapezoid muscle). I was in so much pain. My Blood pressure (no history of high blood pressure ever) was 170 over 101 that day which she attributed to PAIN. I was sent home without examination with Flexaril and Oxycodone which gave me no relief.
3. 17 days later on Sept. 29 after suffering with this pain on the right side of my upper neck and shoulder,and right arm I was seen by an ER doctor who gave a preliminary diagnosis of cervical radiculitis (pinched nerve) again with no xray but diagnosis made solely on my symptoms. Note: My blood pressure when checked into the ER was 201 over 105 with a pulse of 92. I was given three shots, dilaudid, phenergran, and a form of steriod. I was sent home with Hydrocodone, Methacarbomol, and a Medrol dose pack (Steroid). None of this has even touched this pain only taken the edge off a very small amount. Since this time the pain has been so severe I have even seen a psychiatrist to see if I was losing my mind with pain or simply withdrawal from a seventeen year use of clonazepam and was prescribed clonazepam again for anxiety (I was on this previously but my RX had run out on Sept. 12 after this pain began in my right arm and shoulder so there seems to be no relation, only re-introducing the clonazepam did help with the unbearable anxiety caused by the pain.
4. The ER Doctor recommended that I go to a Pain Management Clinic (I have been on Pain Killers since September 12th, 2008. Without doing any tests, xrays, MRI's or any other examination how can a doctor diagnose you with a pinched nerve based solely on symptoms alone? Note: Is a Pain Management Clinic where I should start even though I am in so much pain it even hurts to breathe? Or is there someone else I should see first? The only relief I have is minimal through the use of hydrocodone and a muscle relaxer. When the pain is greatest my muscles just on the right shoulder area and arm spasm so badly I cannot even judge my pain because it goes beyond the scale of a ten, with ten being the highest.
5. Today is Saturday and I am loaded with pain killers, muscle relaxers and more but I see no relief for that until someone helps me.
6. My real question here is do I go to a Pain Management Clinic for help first without a true diagnosis or do something different. I am in so much pain it is difficult to make a decision on what to do next.
Please, Please, someone help me. After nearly a month now I cannot tolerate this pain any longer. It prevents me from doing anything, including working(I do computer work 85% of the time and now can only do that for a minimum of 15 to twenty minutes at the time without intense pain so I have to keep taking too many breaks to complete any project at all. To add to this I cannot even sleep or rest because of the pain even on pain killers.
If there are any real Doctors on this site that can just steer me in a better direction or a more appropriate direction on this I do not need to know your name or who you are I just need help quickly. I have not had a normal day in many weeks. I must also say that I do not have health insurance at this time and I have run into some serious barriers here because of it but I do have an old 401K which was supposed to be my retirement but I am willing to spend it all to feel better. Many doctors will not even see you without Health Insurance but since when did cash not spend? I want and need help so desperately that I will do anything.
Sorry this is so long but I am desperate and I need help. I cannot work like this (cannot perform any normal duties) and it makes it impossible to find a job while I am in this condition. (I was laid off from my job on May 23, of this year but I did not have health insurance benefits anyway.)
Help Me Please Someone!

 
Old 03-16-2010, 04:23 PM   #10
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Re: Diagnosis of Pinched Nerve in Cervical Spine without MRI or xrays

My nerve was diagnosed through MRI. It was an overnight problem. Worked for another three weeks like that and had to stop. Fortunately I am on disability already with Limb Girdle muscular dystrophy. If you can call that fortunate. I do feel much compassion for you as I know your suffering. Spinal surgery seems to be an option but I have regained some use through physio therapy. I am now able to raise myself in and out of tub and have a wider range of motion. I hope this gives you some hope as we must never quit the fight .
Cheers Bryan

 
Old 03-16-2010, 05:04 PM   #11
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Re: Diagnosis of Pinched Nerve in Cervical Spine without MRI or xrays

An MRI may be needed. But without insurance the ER is doing the best they can to try and treat you. Sometimes this type of pain is brief and appropriately treated by what you have received. However if the pain lasts more diagnostic work is needed.

After an MRI most likely a consultation with an Orthopedic Spine Surgeon and/or Neurosurgeon. Most Pain Mgmt doctors will want to see an MRI also to get an idea of what they are treating.

All of this will cost a great deal if you don't have insurance. If you qualify for your state's low income health plan apply immediately. Otherwise contact the nearest public/county hospital and ask of they can advise you on how to get treatment.

Disc disorders in the neck can cause the symptoms you have mentioned, but only an MRI will help.
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