TriMix Injections - Cost

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kristmas
New Member


Date Joined Jan 2013
Total Posts : 2
   Posted 1/14/2013 6:36 PM (GMT -6)   
Hi everyone, new to this forum.  My husband went to a "Specialty Clinic" today for ED.  They steered him away from taking anything like Viagra etc.  Immediately had him try the TriMix injections.  Apparently the injection was successful, but after reading thru this site about TriMix, I think he got ripped off on the price (30.00 per injection).  So, my question is, where do we go from here?  Does a standard urologist prescribe TriMix?  And if so, where might we purchase it once we get the prescription?  We live in Texas.  I've seen several posts about Franck's in Florida, but when I google it I come across all of these FDA warnings about cleanliness etc.
 
 
Thanks for your help!
Kristmas

trimix
Regular Member


Date Joined Oct 2011
Total Posts : 373
   Posted 1/14/2013 7:50 PM (GMT -6)   
Hi kristmas- Sounds like the clinic he went to is certainly taking you and him for a ride....
 
Your husband should go to a Uro that has experience with ED to take a look at what problem your husband has and then make suggestions, which in most cases you start with drugs and then move to trimix if the drugs don't work.
 
If he does end up with trimix, the Dr will make a prescription and there are all kinds of places to get it for a reasonable price.
 
The cost per injection will vary with how much he needs to do the job. $30 for one injection is way to much but it might have been because of them doing the injection. When you are on your own, it will be a lot cheaper.
 
Give us some history on your husband and why he has ED.
 
We are all here to help....you came to the right place.
 
Cheers,
 
Curt
PSA: 5/05-2.008, 12/08-2.87, 2/11-4.357
3/11- 12 needle biopsy, 1 core positive GS 3+3
5/3/11- RP performed, tumor volume 1cc, pT2c all margins and lymph nodes negative
PSA: 8/1/11-.06, 10/26/11-.16, 10/31/11-.17, 10/31/11-.19
11/24/11- Started for 22 days
PSA: 12/16/11- .154 Stopped Avodart
12/22/11 Started Trimix
PSA: 3/12/12- .157
PSA: 6/12/12- < .1 :-)
Age 61

Tigerfan53
Veteran Member


Date Joined Jan 2011
Total Posts : 813
   Posted 1/14/2013 8:19 PM (GMT -6)   
Kristmas – Welcome to HW glad you found us. I agree with Curt - normally you start with pills and then move to injections if pills are not working.

I get my Trimix delivered overnight to Louisiana from Bryce Laboratories in Connecticut. I pay $64 for a 5.1ml vial of Trimix, $22.50 for 30 syringes, and $25 shipping. The dose you use dictates the cost per injection. For example, I currently use 0.15ml per injection; so I can get about 34 injections per vial; which works out to less than $4.00 per injection for me.

I would think any doctor could prescribe Trimix, certainly any uro could. Then you have to find a “compounding pharmacy” that can mix the drugs together. Perhaps you can find one locally or in a nearby city. The reason I get mine from Connecticut is that’s where my ED uro sends all of his patients. If you’d like contact information for Bryce or have other questions email me.

-- Tigerfan
~
Diagnosed Dec 2010 at age 53
09/2010 PSA 4.8
11/2010 PSA 5.1
11/2010 PSA 5.3 after antibiotics
12/2010 Biopsy: 50% in 1 of 12 cores, PIN, G6, T1c
03/2011 PSA 5.6
06/2011 RALP negative margins, G6, pT2b, PNI
09/2011 PSA < 0.05
12/2011 PSA < 0.05
06/2012 PSA < 0.05

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3249
   Posted 1/14/2013 8:23 PM (GMT -6)   
Welcome to Healing Well. You came to the right place.
A little searching here and you will find we have a lot of info on Trimix.

Typically a 5 ml bottle of Trimix sells for $80-$110 with syringes. Depending upon the dose and the individual you might get anywhere from 15 to 100 injections per bottle. So $30 for one injection is very expensive unless it included sitting in the office, having them do the injection, discussing techniques etc.

You need to look for a Compounding Pharmacy that makes "injectables". Look online and call one in your area. They will suggest a urologist they work with.

Congratulations on finding a workable solution.
Jeff
Age: 60, Mar 37 yrs, 56 dx, PSA: 4/09 17.8, 6/09 23.2
Biopsy: 6/09 7 of 12 Pos, 20-70%, Gleason 4+3 Bone, CT Neg
DaVinci RP: 7/09, U of Roch Med Ctr
Path Rpt: Glsn 3+4, pT3aNOMx, 56g, Tumor 2.5x1.8 cm both lobes and apex
EPE present, PNI extensive, Sem Ves, Vas def clear, Lymph 0/13
Incont: 200ml/day ED: Trimix
Post Surg PSA: 10/09 .04, 7/10 <0.01, 7/11 <0.01, 1/12 <0.02
AdV Sling 1/10/11 Dry

Water Guy
Veteran Member


Date Joined Jul 2011
Total Posts : 2403
   Posted 1/14/2013 9:38 PM (GMT -6)   
 I recently visited one of those specialty clinics for ED that advertises on the radio just to hear what they had to say about their advertised new "miracle" for ED. They were offering shots of Bimix or Trimix all prescribed and mixed by their own pharmacy for $20 to $30per shot. I fooled them because I knew more than the tech and maybe the doctor about injections for ED. I told them that they were a rip off and taking advantage of men with serious problems for a ridiculously high price and they should be ashamed of themselves.  I was told that I should leave and not bother coming back.  In my State they call themselves "Alabama ****s Clinic (Full name left out). They also have branches in Georgia, Louisiana and Texas and run the same radio ads just changing the state and phone number.
 
I use double strength Trimix in a 5ml vial for $104 which is enough for 20 or more injections. I use .25ml per injection. Single strength is $60 a vial. If you want to talk to me about this any further send me an email and I will give you my contact information. But as others said above any URO with expertise in ED problems should be able to prescribe Trimix and offer in office injection for the first time. You should also have several compounding pharmacies in Texas that can mix the solution and dispense it to you. We have 2 compounding pharmacies with in 10 miles of my home here in Birmingham.
 
Terry
AGE 61 Dx with fam hist of PC
PSA
1.5 5/09
2.5 6/10
3.5 12/10 ref URO
5.25 3/11 DRE Neg
BX 4/13/11 2 of 12 cores diag both sides 15% & 20% GS7(3+4)
RALP nerve-sparing 6/8/11 path G7 pT2C, Marg-Lymph-Sem-Vas-PNI- organ confined 60% tumor involved 69grms 4.3X4X3 cm
100% dry 7/3/11
post PSA
9/11 <0.07
12/11 <0.04
3/12 <0.01
6/11/12 <0.01
9/26/12 <0.001
TRIMIX injections for 100% ED

Post Edited (Water Guy) : 1/14/2013 7:42:57 PM (GMT-7)


mspt98
Regular Member


Date Joined Dec 2008
Total Posts : 296
   Posted 1/14/2013 11:02 PM (GMT -6)   
Yup, everybody above is exactly right. I got trimix from a local compounding pharmacy here in Baton Rouge, LA with presciptions from operating uro and then local uro for around $100.00/bottle. One vial at .10 ml/shot is like 40 or 50 shots, so those men's clinics are a rip off. The problem is some docs don't want to prescribe trimix for ED since that is an "off label" use of the drug. There definately are uros in your community who will prescribe trimix over edex/caverject which is  about $30/shot. That is a rip off. The problem is knowing ahead of time who will do it, I guess it's hit or miss with MD appointments if you can't find somebody in your community who found a uro in your community willing to prescribe trimix. Caunjeff told me about Dr. Hollier and I am eternally grateful to him for the info...........
My age= 52 at time of diagnosis
DRE=negative,
PSA went from 1.9 to 2.85 in one year, biopsy ordered,
2 cores positive, one 5%,one 25% G=6
Bilateral nerve sparing robotic surgery on 09/11/08, pathological stage T2A,
No signs of spread, organ confined,
all PSA'S 0 since surgery, diagnosed with low T, doing TRT now, still using trimix for ED

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5912
   Posted 1/14/2013 11:22 PM (GMT -6)   
kristmas,
 
E-mail me at the address in my profile. I may have a closer option for you.
Moderator - Prostate Cancer
(Not a medical professional)

DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808
HT (Lupron) 6-mo injection 9/12;Prolia 6-mo inj 12/12

kristmas
New Member


Date Joined Jan 2013
Total Posts : 2
   Posted 1/14/2013 11:23 PM (GMT -6)   
Thanks everyone for your input! I appreciate it so much! We are new to all of this, so hearing from people with experience is a big help. I feel bad that I posted this on the prostrate cancer forum, as my husband doesn't have that, but when I googled this is the only place that had any answers! He is 54, he is a little overweight, a smoker, and has terrible sleep apnea, so I'm assuming all of this has a great impact on his ED. The "men's clinic" said he just had a blood flow problem. Sent him home with .75ml syringes and an auto injector. I'm really concerned that he started him off at that high of a dose. I'm thinking he needs to see a uro. The first injection made things better but still not 100%, so he's discouraged. But I'm concerned about the Viagra etc, and its side effects, and if it would even help.

Thanks again,

I hope you all don't mind me crashing your board.
Kristmas

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5912
   Posted 1/14/2013 11:49 PM (GMT -6)   
Getting to "100%" on the first shot is not likely to happen. There is variation in result from anxiety, stress, a shot that does not hit the proper spot, I could go on ...
 
My first shot was .10 ml, and was ok, and I moved up by increments to .13ml, where I was on the way to the ER at 4 hours. The same amount (~.11) can give me a totally satisfactory result, or something less, depending on the day.
 
I tried all the pills first, not really wanting to do that injection unless I really had to. I'd rather have blue vision than give myself the shot, but the pills didn't work.
 
My Trimix cost varies. Two vials (2x5ml) cost from $159-$179 (retail, depends on the cost of ingredients that week) including 20 syringes and prep pads. I pay less because of the insurance "agreed price".

PeterDisAbelard.
Forum Moderator


Date Joined Jul 2012
Total Posts : 3870
   Posted 1/15/2013 9:06 AM (GMT -6)   
kristmas,

We are all delighted that you found us and glad if we can help. ED is one of the problems on the mind of many of our members and this forum offers a rare opportunity to compare our results and share info.

Your husband would probably be better off if he talked to a urologist about his ED. It sounds like the men's clinic may be a bit too much of a one-trick pony. Not that there is anything wrong with Trimix. I use it myself.

As for his uneven results with the Trimix and his disappointment with his latest results, some guys (again, such as myself) find that it works better standing up than laying down. This can make it work at the doctor's office and not so much at home. Just another data point he can collect and report to his new urologist when he makes that appointment.
60
Slow PSA rise 2007-2012: 1.4=>8
4 bxs 2010-2012:
1)neg (some inflammation),
2)neg,
3)positive 1 of 14 cores GS6(3+3) 3-4%, 2nd opinion GS7(3+4)
4)neg.
Mild Pre-op ED
DaVinci RRP 6/14/12. left nerve spared
Path: pT3a pN0 R1 GS9(4+5) Pos margins on rt
Start 24 mo ADT3 7/26/12
Adjuvant IMRT 66.6 Gy 10/17/12 - 12/13/12
Incontinent, Trimix, VED
Forum Moderator - Not a Medical Professional

Water Guy
Veteran Member


Date Joined Jul 2011
Total Posts : 2403
   Posted 1/15/2013 9:25 AM (GMT -6)   
I would have to agree with our Moderator Peter. Your husband should first have a consultation with a Urologist about his ED as many factors can be the cause. He should have a physical also to make sure that he has no health issues that are contributing to his ED. At his age and given that he  smokes his problem could be as simple as low Testosterone which can be checked by a blood test and treated easily.
 
Most large Urology practices, specially ones that deal with prostate cancer, also have an ED specialist on staff. These "men's" clinics like the one I visited locally IMO are praying on desperate men without delving into the underlying cause for male ED. The one here in Alabama wanted to do a PSA, Testosterone test and then an Ultrasound only prior to an injection with their ED miracle drugs. My first thought that this clinic may not be legit, was that they did not accept any insurance for their initial visit and wanted $199 for the tests and  first injection.  Most insurance will cover the cost of the doctor visits and tests to diagnose ED but may not cover the cost of the drugs to treat the problem.  However if they think one of the orally taken drugs can help with ED most doctors have samples for free that you can experiment with.  I had ED for several years prior to my prostate cancer and surgery which was caused by my hypertension meds that I take. I found that the smallest dose of Viagra 25mg gave me great results with very mild side effects.
 
Good luck and please feel free to visit us if you have any more questions and concerns.
 
Terry
AGE 61 Dx with fam hist of PC
PSA
1.5 5/09
2.5 6/10
3.5 12/10 ref URO
5.25 3/11 DRE Neg
BX 4/13/11 2 of 12 cores diag both sides 15% & 20% GS7(3+4)
RALP nerve-sparing 6/8/11 path G7 pT2C, Marg-Lymph-Sem-Vas-PNI- organ confined 60% tumor involved 69grms 4.3X4X3 cm
100% dry 7/3/11
post PSA
9/11 <0.07
12/11 <0.04
3/12 <0.01
6/11/12 <0.01
9/26/12 <0.001
TRIMIX injections for 100% ED

Post Edited (Water Guy) : 1/15/2013 7:29:54 AM (GMT-7)


Brad g
New Member


Date Joined May 2013
Total Posts : 3
   Posted 5/5/2013 7:38 PM (GMT -6)   
I get my trimix through the Ottawa Civic Hospital Pharmacy. It costs about $75 for 50 Ml and I use between 3 to 5 ml per injection. I started at a much higher dose but have found that 50 to 100 mg of viagra or cialic an hour before gives good results and assists in reducing the length of the erection.
I had my prostate taken out in November 2010 and had no success with drugs for a year and a half. The trimix results in 20 year old erections that are so hard for an hour they hurt, but we love it.
Try getting the trimix through your local hospital urology doctors.

Kaibil
New Member


Date Joined Apr 2013
Total Posts : 11
   Posted 10/18/2013 3:41 PM (GMT -6)   
Hi:
I am currently using Caverject 40mcg, I use 20mg (½ the vial) on Saturday (50ml) and 20mg (the other half of the vial) on Sunday. I pay $50.00 per carton and it brings 6 vials. I will be changing insurance on November 1st and Caverject is not covered. I do not have an urologist just my Primary Care Doctor, before I ask him for a script, I need to have all my ducks in order. A few questions I have:
1) If I am using ½ a vial or 20 micrograms per injection how much do I need of Trimix or how is the script supposed to be written?
2) Reading the old post, I went to Franks in Ocala but apparently the FDA is after him. Which would be my best bet for pharmacy?
Any help will be appreciated.
Thank you
Mario

JStars
Regular Member


Date Joined Oct 2005
Total Posts : 455
   Posted 10/19/2013 8:19 AM (GMT -6)   
Kaibil,

You could probably use a fairly strong trimix prescription since you are using 20mcg PGE-1 already...

Trimix prescription:
20mcg PGE-1
30mg Papaverine
1mg Phentolamine

With luck you won't use too many units per shot -- giving more shots per vial. A few mail-order places have good prices .. Pharmagen was mentioned as one (in Connecticutt).
Age 57 at DX (now 62), 02/03/09 open RRP surgery

bluebird123
Regular Member


Date Joined Aug 2012
Total Posts : 425
   Posted 10/19/2013 9:47 AM (GMT -6)   
Pharmagen Laboratories
Stamford, CT
800 798-7279

This is the lab used by Dr. John Mulhall, ED doctor at Sloan Kettering for his patients. They have good prices and ship all over the country.

This lab was formerly known as Bryce Laboratories.
7/12 PSA 5.2
8/12 Biopsy, 7 out of 12 cores positive, 5% to 70%, 6 cores G6 and 1 core G7 (3+4)
Age 60, diagnosed and treated at age 59
RALP October 2012, Gleason 3+4, negative margins
Continent

Post Edited (bluebird123) : 10/19/2013 8:50:57 AM (GMT-6)


azsunshine2013
Regular Member


Date Joined Aug 2013
Total Posts : 83
   Posted 10/19/2013 10:08 AM (GMT -6)   
Once you get a prescription, you can purchase it from any compounding pharmacy. Call them and get a price.

Our doctor believes in aggressive penile rehab soon after surgery. He said pills for erections are a waste of money for about a year. Dave does do daily Cialis for therapy. But Trimix is our new friend!

His shots end up being about $3 per shot.

This is where we get ours. They ship nationwide, but we live close so pick it up.

http://avella.com

Post Edited (azsunshine2013) : 10/19/2013 9:12:34 AM (GMT-6)


breynrx
New Member


Date Joined Nov 2013
Total Posts : 2
   Posted 11/8/2013 2:21 PM (GMT -6)   
Hello everyone, It seems like the common inconvenience that many people have with using the TriMix injections, is not only the cost of going to a "specialty clinic" but having to go in for the treatment as well. TriMix is offered to men with ED without it being prescribed from a urologist. I have had great success with preforming self injection in the comfort of my own home while still being under supervision of a licensed physician. I use a company based in Chicago which specializes in anti-aging hormones and sexual enhancement medicines. All I had to do was submit a premedical history form which took only about 5 minutes over the phone with a representative and my order was then submitted. I placed my order on a Friday and it came through the mail that next Tuesday. It was cheaper than going through a clinic and a little less embarrassing. I would be more than happy to give the contact information to anyone in need. Take care everyone and know there are options out there.

Not sure about this one. See my note below. -- PeterDisAbelard

Post Edited By Moderator (PeterDisAbelard.) : 11/8/2013 12:45:29 PM (GMT-7)


PeterDisAbelard.
Forum Moderator


Date Joined Jul 2012
Total Posts : 3870
   Posted 11/8/2013 2:44 PM (GMT -6)   
Breyn Rx,

Two warnings about this forum:

1) We generally discourage people from posting recommendations for sources of products when we suspect they may be financially interested. (ie. spam) What is your interest in Prostate Cancer? Do you have a problem we can help with? A story to tell? How can you convince us that you are not just spamming us for a semi-sketchy compounding pharmacy?

2) We have had a number of members (sorry about the pun) that wound up in emergency rooms while they were doing their first few Trimix injections. The dosing is finicky for men who respond strongly and close medical supervision seems necessary. That embarrassing trip to the urologist for one's first jab is actually a good idea. I'm not sure that the 'supervision' of a 'licensed physician' on the phone from Chicago is a sufficient safeguard.

All that said, Welcome to the forum. Tell us a bit about yourself.
60
Slow PSA rise 2007-2012: 1.4=>8
4 bxs 2010-2012:
1)neg (some inflammation),
2)neg,
3)positive 1 of 14 GS6(3+3) 3-4%, 2nd opinion GS7(3+4)
4)neg.
Mild Pre-op ED
DaVinci RRP 6/14/12. left nerve spared
Path: pT3a pN0 R1 GS9(4+5) Pos margins on rt
Start 24 mo ADT3 7/26/12
Adjuvant IMRT 66.6 Gy 10/17/12 - 12/13/12
Leaky but better, Trimix, VED
Forum Moderator - Not a Medical Professional

bobkmn
Regular Member


Date Joined Dec 2013
Total Posts : 20
   Posted 12/2/2013 10:03 AM (GMT -6)   
Hello all. After a long time of looking for answers/information on the subject of penile injections I luckily found this forum. I am not a prostate cancer patient, but hope that posting here is still ok. I am in the process of getting a prescription for injections to hopefully help with my ED. My urologist is going to prescribe trimix and says that he knows of a good compounding lab in the Minneapolis area. I still am interested in information regarding general pricing and such. Also I am on medicare and a private supplement prescription plan but they do not cover any of the meds, injection or otherwise. Since this is a time frame during which I can switch providers, does anybody here know of a provider that does cover penile injection meds like trimix. I understand if you do not feel comfortable providing or if the forum prohibits such recommendations. It is just, as most of you I am sure already know, finding reliable information on this subject is not an easy task.

I am glad that I found this forum and its remarkable members. Oh, I am a 67 yr old male living in the Twin Cities area.

Thank you!

PeterDisAbelard.
Forum Moderator


Date Joined Jul 2012
Total Posts : 3870
   Posted 12/2/2013 10:44 AM (GMT -6)   
Bob,

Perhaps someone will correct me but I don't think you will have much luck getting any insurance company to pay for your Trimix. I seem to recall a few guys who got help from their insurance company but they did so by having their surgeon write a note that the ED was a result of a covered surgery.

That's the bad news. The good news is that Trimix is almost always the least expensive ED treatment on a per-use basis when you are paying cash. I pay about $150 for a 5ml vial of Super Trimix from which I get 25 jabs. That works out to around $6 per injection and, because I have a bit of a venous leak I use more than most guys. If I shopped around a bit I could probably drop that down to about $4 by ordering online from one of the high-volume compounders.

Welcome to the forum.
60
Slow PSA rise 2007-2012: 1.4=>8
4 bxs 2010-2012:
1)neg (some inflammation),
2)neg,
3)positive 1 of 14 GS6(3+3) 3-4%, 2nd opinion GS7(3+4)
4)neg.
Mild Pre-op ED
DaVinci RRP 6/14/12. left nerve spared
Path: pT3a pN0 R1 GS9(4+5) Pos margins on rt
Start 24 mo ADT3 7/26/12
Adjuvant IMRT 66.6 Gy 10/17/12 - 12/13/12
Leaky but better, Trimix, VED
Forum Moderator - Not a Medical Professional

bobkmn
Regular Member


Date Joined Dec 2013
Total Posts : 20
   Posted 12/2/2013 10:58 AM (GMT -6)   
Peter,

Thank you for the information and your welcome to the forum. I will continue to read the posts and post myself should I encounter any questions I need answers for.

Bob

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5912
   Posted 12/2/2013 9:17 PM (GMT -6)   
The "retail" price quoted on my trimix receipt has varied from $150 - $180 over the last few years, and changes almost every month. The "agreed" price with the insurance company hovers between $90 - $150, also changing every month.

I pay the agreed price out of pocket until I meet my ultra-high deductible, and then pay 15% of the agreed price until I hit my out-of-pocket max.

My dispensed amount is 2 vials of 5ml. My use is .10 -.11 ml per shot.

It took several letters, dozens of phone calls, and a serious intervention from the pharmacy (a local, highly respected, family-owned company) in which they argued that the ED I suffer is a direct and absolutely identifiable result of my surgery, and lack of treatment could result in extreme depression, if not worse. My doctors (GP & Uro) had to provide letters stating that I had never complained about ED issues in the past, that I had no known physical issues of that nature before surgery, and that total ED was expected as a result. The insurance company argued that since I was warned, I had to assume responsibility. The pharmacy got it changed. I don't know how, and refuse to upset the apple cart by insisting to know.
Moderator - Prostate Cancer
(Not a medical professional)

DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808
HT (Lupron) 6-mo injection 9/12;Prolia 6-mo inj 12/12, 06/13

zampilot
Regular Member


Date Joined Aug 2009
Total Posts : 152
   Posted 12/3/2013 11:01 AM (GMT -6)   
BobKmn, Custom RX in Richfield was my trimix supplier but due to the new FDA, they got out of that business. They still make trimix gel, so give Roy a call, CustomRx.
I get my trimix through Fairview Pharmacies now, $240 for 5 ml of a strong formula so I use .13-.15/ml and it's good for 2 hours.
I'm in the north metro.

bobkmn
Regular Member


Date Joined Dec 2013
Total Posts : 20
   Posted 12/6/2013 9:19 AM (GMT -6)   
zampilot, I am still working with my uro to begin my use of trimix. My next appt with him is in January. He told me that he has a compounding lab he deals with regularly. They have had to move locations, but should be up by mid-Dec if not already. I am in the north metro as well. Thanks for your note.

LVLFNXS
New Member


Date Joined Mar 2014
Total Posts : 1
   Posted 3/7/2014 2:26 PM (GMT -6)   
Hello all. I'm new to all this. I've read most of the posts in this thread. I'm 39 and dealing with PE, a side effect of antidepressant induced ED. Since I've been off my AD meds, I no longer deal with ED, but now have terrible PE. No stamina at all.

I too have had a consultation at a men's clinic and they preformed a test shot, worked well. I too am looking for a reasonable resource for TriMix.

From what I read, I have to see a Uro first. Is there anyone here that knows of a Uro in the South Seattle, WA area that is known for prescribing TriMix?

Thank you for all the info presented so far. There is hope!!
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