anti-depressants anyone?

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F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3992
   Posted 2/26/2010 9:50 AM (GMT -6)   
i have my first consultation with the radiation oncologist next monday and will probably begin ADT in the next couple of weeks. trelstar is the drug that was mentioned by my uro. i'm worried about depression when i start ADT and continue down the treatment path which will also include brachy and IMRT.

i was diagnosed with PC 2.5 weeks ago but my first abnormal PSA (6.8) was detected more than three months ago. it's been a rollercoaster of emotions and at times it has been nightmarish.

i have a great support group and the best wife in the world. these days i find that i don't like to be alone much. my dog really helps but i am really clinging to my wife. and i spend alot of time talking to friends and others who i have recently met with some connection to the disease or illness in general. i also pray for strength and attend 12-step meetings. i am a recovering drug addict with almost 20 years clean.

my emotional spikes center around my doctor visits. after biopsy i was elated and i was crushed when cancer was later diagnosed. i experienced some calm a couple of days before the big consultation with my family and uro and the best days i have had since this journey began when we walked out of the doctor's office with positive news. but that lasted only a couple of days.

now i feel hopeless again. but not all the time. i usually feel okay early in the morning but it gets worse through the day and i feel terrible at night. reading this forum has been torture for me but i can't stop. it seems like all the news is bad. or at least most of it.

my wife took anti-depressants for years but has been free of them for more than a decade. she has a healthy respect for the drugs because she had both good and horrible experience with them. nevertheless she thinks they may help me get through this a little easier and i am terrified that i may get depressed when i start ADT.

i'm not a depressed person in general and even tho i have been feeling hopeless at times i still work (such as it is), cycle, go to the gym and seek out people to interact with.

i'm not looking for anyone to fix me. i know me pretty well. what i want to know is if you considered or used anti-depressants or any other drugs to get you through the hard times.

oh, i do take 5 mgs. of ambien now to sleep and it really helps. when i take the pill at night i experience a sense of well being in about 15 minutes that i wish i felt all the time, and then i go to sleep for about four hours. i usually can get back to sleep if i stay in bed, especially if i exercised during the day. so the ambien does help alot.

ed r.
age: 54
PSA at diagnosis: 6.8
no symptoms, no prostate enlargement
12/12 core postive....gleason 3+4 = 7
sold on ADT, brachy and IMRT

Post Edited (F8) : 2/26/2010 8:04:29 AM (GMT-7)


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 2/26/2010 10:06 AM (GMT -6)   
FB,
Not a thing wrong with taking those meds if need be. Sounds like a number of positives are helping you thru this, so it might be a short term use and then like your wife you can wean yourself off of them. These are trying times in our life's, and would rather take a good med than try to drink it away. It sounds like some anticipatory anxiety on your part, such as the fear of ADT and clinging to your wife. But anxiety and depression are often flip sides of the same coin. Get with a good DR or Psychiatrist if you chose to go the med route as sometimes it takes awhile to find the right med. Keep us posted and keep up the exercise as it is sometimes the best medication out there.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margin slightly involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only, now none
 started ED tx 7/17, slow go
Post op dx of neuropathy
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Starting IMRT on 1/18/10
Great family and friends
Michael


F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3992
   Posted 2/26/2010 10:19 AM (GMT -6)   
thanx Michael -- as a recovering drug addict i have to be careful with medication and i do think my problem is anxiety but i fear ADT could trigger depression. it's maybe just an irrational fear like the one that tells me i don't have long to live. the good news is i don't want to drink or use street drugs. but after all this time my disease (addiction) is a bit more cunning than that.

ed r.
age: 54
PSA at diagnosis: 6.8
no symptoms, no prostate enlargement
12/12 core postive....gleason 3+4 = 7
sold on ADT, brachy and IMRT


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4119
   Posted 2/26/2010 10:36 AM (GMT -6)   
F8 your fears for ADT are real to you and I do understand the anxiety about starting treatment. If I were you I would discuss this with you GP or Uro. Both of them should have experience dealing with clients that have been in your shoes. Best of luck.

Jeff T
Cajun Country
Jeff T Age 57

9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable

10th month PSA <0.01
1year psa <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next. Next step injections.
15 months out injections Caveject (success)


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 2/26/2010 10:54 AM (GMT -6)   

(revised to say keep your eye on the prize)

Post Edited (zufus) : 2/26/2010 1:19:17 PM (GMT-7)


F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3992
   Posted 2/26/2010 11:04 AM (GMT -6)   
zufus -- thanx i will e-mail you. i know lexapro is addicting but as long as its use does not lead to heroin and can help me get through this ordeal it's something i will consider. my two priorities now are to keep my primary disease (addiction) in remission and to kill the cancer.

will it get easier for me without drugs? afterall i am new to the cancer thing.

i have a great support group and wife but if you are a constant downer people will pull away from you, and i don't need that now. e-mail coming buddy.

ed r.
age: 54
PSA at diagnosis: 6.8
no symptoms, no prostate enlargement
12/12 core positive....gleason 3+4 = 7
sold on ADT, brachy and IMRT


F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3992
   Posted 2/26/2010 11:12 AM (GMT -6)   
corvetteman3 -- thanx. i put a call in to my uro yesterday and i was going to call my general today. maybe i will wait until i see the oncologist on monday. you know when i see guys talking about ED it really gives me hope because that's been one of the last things on my mind since this journey began.

ed r.
age: 54
PSA at diagnosis: 6.8
no symptoms, no prostate enlargement
12/12 core positive....gleason 3+4 = 7
sold on ADT, brachy and IMRT


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 2/26/2010 12:23 PM (GMT -6)   
Hello Ed,

I needed to read your post several times before I answered, wanted to make sure I understood where you were coming from.

First, all of us have gone through a period of fear and depression after getting a prostate cancer diagnosis. I would have to say that is an expected and normal reaction. Some men also go through a period of anger and denial. Since you have a treatment plan in place, sounds like you are past that point.

You also expressed a very supportive wife (a most important assset), I am married to a caring nurse. You have friends, family, and even a dog. So you already have a core of your support team in place. Many of us have that, but there are those that have to fight this alone, and that is sad.

I have never been on the hormone part of your treatment plan, but many here have. But remember, just because something can cause certain side effects, it doesnt mean it will to you, just means it could. We have several brothers here that have gone your route, with the seeding and the IMRT, so there is a lot of available help when and if you need it.

You being a recovering or recovered drug adict concerns me when in relationship to the subject of anti-depressents. I am a big believer in them for anyone that really needs them. In my more distant past, I was on Lexapro for about 3-4 years. When I decided to stop using it, didn't feel I needed them, I quit cold turkey, never had any withdrawal problems and that was probably 5 or more years ago. But every body reacts differently. If you feel you need them, then you should have good open talks with your GP and any other doctor that is or will be treating you, make sure that each of them knows your situation, so there won't be any mix up.

I have been on Ambien for over 10 years. There were periods of non-health insurance when I didn't have any for 2-3 months at a time, and I didn't have a problem, other than having a harder time of not getting to sleep. I should add that I come from a family of insomniacs.

Also, you will find the support, encouragment, and general care here with the brothers and sisters at HW to be genuine and great. This place has been an important part of my dealing with prostate cancer. Real friendships have been made here.

We don't judge another person's treatment choice. We try to be honest with the posts, yes, sometimes, you will read some heartbreaking things, other times: you will crack up laughing from some of the clowns and smart "a" here, and we all cheer together when any of us gets some good news, a good test result, etc. We call it a brotherhood, and in reality it is.

Prostate Cancer can be a mean basterd (misspelled on purpose), and for some, a really tough fight. There are no dumb questions, and knowledge about this cancer is the single best way to abate your fears and worries. There is strength in knowledge.

We are here for you, I hope you keep posting, and keep reading.

We may fight different battles on different days, and sometimes our paths go in different directions, etc, but there is one thing for certain, we hate this thing called Prostate Cancer, and we battle together as a team against the beast. You are welcome to be a part of our team, can't have enough warriors.  We will help you fight too.

David in SC


Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 in at the same time, 2/8-Cath #11 out - 21 days

Post Edited (Purgatory) : 2/26/2010 10:27:20 AM (GMT-7)


F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3992
   Posted 2/26/2010 3:45 PM (GMT -6)   
David -- thank you. your post means a lot to me because i see you dealing bravely with your situation which my mind tells me is worse than mine. i believe in doing whatever it takes to survive and i believe you can't save your arse and face at the same time. i have nothing but respect for you.

man i just feel terrible sometimes. i haven't led an easy life prior to getting clean but this is like a nightmare. i think i'll sit on my hands till monday and talk it over with the oncologist. the worst time for me is the nights but at least the ambien helps. thanx again.

ed r.
age: 54
PSA at diagnosis: 6.8
no symptoms, no prostate enlargement
12/12 core positive....gleason 3+4 = 7
sold on ADT, brachy and IMRT

Post Edited (F8) : 2/26/2010 1:56:21 PM (GMT-7)


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4119
   Posted 2/26/2010 7:27 PM (GMT -6)   
Ed: You know you are welcome to call me at any time. My e-mail is open and If you need my number just let me know. Hang in there buddy Monday is just around the corner.

Jeff T
Jeff T Age 57

9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable

10th month PSA <0.01
1year psa <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next. Next step injections.
15 months out injections Caveject (success)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 2/26/2010 7:44 PM (GMT -6)   
Ill match Jeff's offer above, my email is public, and if you ever want to to talk by phone, be happy to supply you with the number.

The fact that you have made yourself "clean" is great, something to be proud of, and you don't need to have prostate cancer take that away from you. We all have our secret demons in our lives, one is not worse than the other in my opinion.

Jeff, above, is a great friend I have met here on HW, I always look forward to hearing from him by phone, he's a good man, and a good friend.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 in at the same time, 2/8-Cath #11 out - 21 days


F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3992
   Posted 2/26/2010 9:52 PM (GMT -6)   
Jeff and David -- you guys are awesome. thank you for your support :-).

well if this thread is any indication the use of anti-depression meds just isn't that common when dealing with PC. that's not what i would have thought at all.

ed r.
age: 54
PSA at diagnosis: 6.8
no symptoms, no prostate enlargement
12/12 core positive....gleason 3+4 = 7
sold on ADT, brachy and IMRT


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 2/26/2010 10:13 PM (GMT -6)   
Ed,
I think depression is fairly common with PCa, but we all deal with it in different ways. You have to look at your own brain chemistry and any family history of depression that might make meds a better option. You might also pump into an anti med mind set in the recovery community, but there are lots of good meds that are not addictive. Be true to yourself and be honest with yourself and you will find the answer. Best to you Ed.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margin slightly involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only, now none
 started ED tx 7/17, slow go
Post op dx of neuropathy
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Starting IMRT on 1/18/10
Great family and friends
Michael


pasayten
Regular Member


Date Joined Mar 2007
Total Posts : 447
   Posted 2/26/2010 10:29 PM (GMT -6)   
I have had some serious battle on the depression front.    I would just add that a Psychiatrist well versed in the current medicines and regimes will most likely dial you into a much more successful and timely recovery period than a family doctor who just may know a working knowledge of the various meds.
 
A mistake that I made was going off the meds unsupervised on my own schedule which made subsequent episodes harder to deal with initially.   You need to scale back on the meds if applicable under the supervision of the doctor according to set schedules.
 
Anyway,  under proper supervision of meds and other factors including other therepies if indicated,  and family/spiritual support,   life can be lived without the darkness or hinderances of depression and anxiety.
 
pasayten
After 3-4 years of annual PSA 4-6, biopsy recommended
3/13/2007 - 12 point biopsy - Left 0/6  Right 1/6 Gleason 3+3 T1c
4/24/2007 - DaVinci performed at Virginia Mason hospital in Seattle
5/2/2007 - Catheter Out! Final pathology of Gleason 6  T2c Nx Mx, approx 20% of prostate involved, positive margin, but only at 2 focal points.  
6/28/2007 9 weeks incontinance... Overnite, went from 4-6 soaked pads a day from prev 8 weeks to 2 barely wet pads a day.
7/12/2007 11 weeks post-op  Minimal leakage...  one small pad a day
7/18/2007 First Post-Op PSA...  0.01 !!! 
9/10/2007 Pad free and ED at 75% with 100mg Viagra generic
6/26/2008 2nd Post-OP PSA at 14 months...  0.02 
12/2/2008 3rd Post-OP PSA at 20 months...   0.03
10/30/2009 4th Post-OP PSA at 31 months...   0.13 (moved and diff lab)
11/3/2009 Retest at my original lab...  0.11  (followup with Doc sched 11/10)
11/10/2009 Discussion indicated biochemical reccurrence and need for salvage radiation treatment. 
1/21/2010 Another PSA test at 34 months...  0.14
1/26/2010 IMRT Salvage Radiation Treatment started
                  32 sessions for 64 gys total.
2/24/2010 19 down and 13 to go...  No side effects to date except a little
tiredness.  Sometimes feel like a slight sunburn on the inside for a few hours after treatment.
 


F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3992
   Posted 2/26/2010 10:30 PM (GMT -6)   
Michael -- i hear you and thank you! there are pleny of recovering folks who take anti-depressants without running amok and returning to their drug of choice. in fact many would probably go out if they weren't emotionally stable. i know as an addict i'll always want to take something whether i need it or not. that HAS to weigh into my decision.

the drug that takes most addicts out from what i've seen in the past couple of decades is vicodin. xanax is another. and oxycontin of course.

Ohio State -- i have already exchanged e-mails with Zufus. i'm glad he gave me the invite because i have been wanting to get his point of view for awhile.

thank you both for taking interest in my concerns. you both have been added to the awesome list cool .

ed r.
age: 54
PSA at diagnosis: 6.8
no symptoms, no prostate enlargement
12/12 core positive....gleason 3+4 = 7
sold on ADT, brachy and IMRT

Post Edited (F8) : 2/26/2010 11:45:39 PM (GMT-7)


F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3992
   Posted 2/27/2010 1:44 AM (GMT -6)   
thanx pasayten. my wife agrees that if i were to take anti-depressants they should be prescribed by a shrink of some sort. thanks for sharing your struggles with me.

ed r.
age: 54
PSA at diagnosis: 6.8
no symptoms, no prostate enlargement
12/12 core positive....gleason 3+4 = 7
sold on ADT, brachy and IMRT


Im_Patient
Veteran Member


Date Joined Aug 2009
Total Posts : 669
   Posted 2/27/2010 1:45 AM (GMT -6)   
F8, I know where you are coming from with bouts of depression over this cancer. I am usually cheered up when I see the doc but then discouraged when I start delving into the research and statistics. What has helped me a lot is my faith (don't know where you are with this). The depression leaves me when I admit that I have done what I can, made the decisions I need to right now, and past that, this is entirely out of my hands and entirely in God's hands. Giving myself permission to rely on Him really helps. Just speaking for myself...
I wish you all the best, and for what it's worth to you, I'll be praying for you.
Jeff
Gleason, 3+4; PSA, 7.9
Robotic Prostatectomy, March 2008 (Age 48 then), nerves both sides spared, post surgery analysis confirmed 3+4 Gleason,
pT2c, prostate 60.2g, margins: negative; perineural invasion: present; lymphatic invasion: present; 3 lymph nodes removed, clear; seminal vesicle invasion: absent; Gleason 4 comprises 5-10% of carcinoma
PSA consistently <0.1 since surgery until Oct 09, 0.1; retested Oct 09, <0.1,
Jan 10, 0.2
retest Feb 1 confirmed 0.2
CT scan, bone scan Feb 10 both clear


JoeFL
Regular Member


Date Joined Oct 2009
Total Posts : 420
   Posted 2/27/2010 10:06 AM (GMT -6)   
F8 -

You have more going for you than you think if you have been clean for almost 20 years. I am a recovering alcoholic who has been sober for 23 years so I can relate. You beat the drugs and you can beat PC too. As you can see below I chose the same treatment path as you with the exception that I am not taking any hormones (does your treatment have to include hormones?). So far, the side effects have been minimal and in line with what I was told to expect. Once you have chosen a treatment and started it, cut yourself some slack.....you have done all you can and it is then out of your hands.

I can't help with the depression medication question. However, my wish for you would be for you to not have to take anything that would put your clean streak at risk. Best wishes on the journey.

Joe

Age -67 PSA - 4.5

Biopsy  (9/4/09) - Positive in 5 of 8 cores. In those 5 cores, 5 of 11 samples were positive. Gleason 3+3=6. Stage – T1C  Ct and Bone scans negative.

 

BT performed on 12/11/09. 84 seeds of Palladium 103. Surgery at 7:30 - Home at 12:30 same day with no catheter. Blood in urine for a week. Side effects as expected -  some burning, frequency, urgency.   Resumed daily  1 ½ mile walk after 3 days. Side effects have subsided some in the last week.

 

BT followed with 25 IGRT treatments beginning Feb 15 (4500 Gy's). 

 


F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3992
   Posted 2/27/2010 11:20 AM (GMT -6)   
Jeff -- belief in a higher power is one of the necessary components of the 12 steps. i believe my higher power led me to the doctor this time, and brought me to the program nearly 20 years ago. i believe in the power of prayer and i do believe in miracles. my spiritual side has been weak but i am working on it. thank you for your thoughts.

i pray for strength. i pray for peace of mind. i pray for my wife who i believe was also sent to me. they say that recovery is a process and not an event. hopefully the same holds true for the restoration of faith.

ed r.
age: 54
PSA at diagnosis: 6.8
no symptoms, no prostate enlargement
12/12 core positive....gleason 3+4 = 7
sold on ADT, brachy and IMRT

Post Edited (F8) : 2/27/2010 9:24:19 AM (GMT-7)


F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3992
   Posted 2/27/2010 11:47 AM (GMT -6)   
Joe -- i know for a fact that i am blessed. i have a tremendous life. i couldn't imagine doing this alone, strung out or incarcerated.

i feel better this morning. i went to a meeting last night and afterwards me and a buddy went to dairy queen and had an ice cream cone which of late has become a tradition. he was my best man 11 years ago and has more than 30 years clean. he told me about his dark days when he thought he was ill and how he was feeling....which is very similar to how i feel. it really helps to know that how i feel is normal, or at least in the normal range.

he's never taken anti-depressants but he said: "why not if it helps you get through this". i have several friends in the program who are taking or have taken interferon. nowadays almost everyone starts on wellbutrin or lexapro first because the side effects of that stuff are horrible and the duration of treatment is generally a year.

anyhow i came home and snuggled with my wife and we watched dirty jobs. i took my 5 mgs of ambien and we started nodding about the same time. that was about 11:30. besides peeing i woke up about 3:30 and every hour or so until i finally got up and 7:45....i heard my dog yawning which means she has to pee. i took her out and let our outside cats out of my wife's detached office, and fed them. i then put on a load of laundry and a pot of coffee and i let our indoors cats out of their cage in the garage and fed them.

we had a heck of a storm yesterday but today is beautiful. i'll probably avoid yard work again this weekend but i'll either do my 18 miles on the bike or go to the gym depending on the weather. i almost feel like making a few pictures but not quite. i'm feeling pretty good this morning and i hope it lasts through the day. i'm less certain about anti-depressants now than i was two days ago. i'm not a depressed person and i believe my anxiety is normal and situational. my wife thinks i will feel better after the consultation monday.

thanks for your concern and thoughts and sorry for the ramble wink.

ed r.

p.s. from everything we have read the ADT as a first course of treatment makes sense. it's up to me to deal with the side effects.
age: 54
PSA at diagnosis: 6.8
no symptoms, no prostate enlargement
12/12 core positive....gleason 3+4 = 7
sold on ADT, brachy and IMRT

Post Edited (F8) : 2/27/2010 9:57:38 AM (GMT-7)

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