Monday, March 7, 2011

The importance of the cardiac physical exam?

If it hasn't seemed apparent enough in the previous posts, I once again want to stress the importance of the physical exam.  By taking the time to thoroughly examine the patient, which includes a thorough history, tragic events like this can be avoided.

Numerous things should happen during any physical exam, but the cardiovascular exam should include: visual examination, palpation, and auscultation; with most of the focus on the neck and chest.

So what to do...

Take a few blood pressures.  Check each arm and one leg, normally the leg will have the higher blood pressure.  If not, add coarctation of the aorta to the differential.

Feel for pulses.  While weak distal pulses does not have to mean pathology, left ventricular hypertrophy is one possible cause.  Keep in mind that LVH occurs due to conditions such as AS, IHSS, AR, MR, and event HTN.

Look at the eyes.  Using the ophthalmoscope check for neovascularization, which suggests the blockage of arteries having resulted in the formation of new ones.  Two important disease entities to consider if you see this: diabetes, and coronary artery disease.

Examine the neck.  This means giving more than a shear glance and looking at the internal jugular vein, which includes checking for differences during inspiration and expiration; and listening for bruits in the carotid arteries.

  • Bruit: the turbulent flow of blood past an obstruction, otherwise understood as the abnormal sound blood makes as it passes an obstruction.  Because of the pumping of blood the bruit will make two sounds--the upstroke and the decline.  The importance lies in the speed of the upstroke and the speed of the decline, which together can aid in a diagnosis.
    • Rapid upstroke, Rapid decline: aortic regurgitation 
    • Rapid upstroke, Delayed decline: IHSS
    • Delayed upstroke, Delayed decline: aortic stenosis
    • Slow upstroke, Normal decline: atherosclerosis, only occurs in the carotid with the plaque
  • Internal Jugular Vein: correlates with pressure in the right atrium.  The pulse should normally be seen around 5 centimeters above the Angle of Louis of the sternum.  To look for this the patient should lay on the table at an incline of 30 to 45 degrees.  For comparison: 10cm from the Angle is the mandible; at 12cm is the ear lobe.  Two important entities need consideration when checking the internal jugular: 
    • Hepatojugular Reflux: a sign of right atrial overload, will stay elevated on inspiration and expiration.
    • Kussmual's Signs: distention of the internal jugular with inspiration; suggestive of pericardial effusion and impending respiratory failure.
Next, move on to the chest.

Palpate the chest.  Particularly check three areas:
  • Apex: should be at the left 5th intercostal space at the midclavicular line, but can vary slightly depending on the heart's deviation.  However, barely feeling it during S4 suggests a small heart, where as a large heart will generally create a sensation across all palpating fingers during S3.
  • Sternum: roughly located above the right ventricle.  Normally one will not feel it; only right ventricular hypertrophy is felt.  If felt you should add tricuspid regurgitation to your list, auscultating a systolic murmur in the tricuspid area would only further support this diagnosis.
  • Sternal border: correlates well with the left atrium, and just like the right ventricle it will only be felt if enlarged.  With left atrial enlargement consider disease states such as mitral stenosis, mitral regurgitation, and dilated cardiomyopathy.
Listen to the heart.  Listen for heart sounds and check for murmurs.  Focus on the four main areas:
  • Aortic: the right 2nd intercostal space
  • Pulmonic: the left 2nd intercostal space
  • Tricuspid: the left sternal border
  • Mitral: the left 5th intercostal space at the midclavicular line
And of course: always take a good history

More on heart sounds and cardiac history taking later...


Unfortunately the physical exam has lost its importance to many practitioners.  

In lieu of looking, listening, and palpating CT, MRI, US, and XR have come in as replacements.  While radiographic and ultrasonographic imaging have benefits, they have downsides as well.  After all, a physical exam doesn't expose the patient to radiation, require a contrast medium, or cost any more money than the salary to employ the practitioner.  But in a society clamoring for big money lawsuits clinicians need to protect themselves, and imaging modalities can provide conclusive answers without the subjectivity of the clinician's skills.  

Some medical schools require their students to do rotations in rural areas, which often lack the bells and whistles of large cities.  It is unfortunate that the bodies which govern medical education across the board don't mandate such training.  Only when one must go without reliance on imaging will he or she learn to appreciate a good physical exam.  

ResearchBlogging.org
Jauhar, S. (2006). The Demise of the Physical Exam New England Journal of Medicine, 354 (6), 548-551 DOI: 10.1056/NEJMp068013

42 comments:

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    1. MILLER AARON,
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      MILLER AARON,
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    1. MILLER AARON,
      Hello everyone am MILLER AARON and i am from USA i am here to testify about an herbal doctor called Dr,IFADE I was heartbroken because i had very small penis,not nice to satisfy my wife and that always bring conflict between us and almost tear us apart, i have used so many product which doctors prescribe for me, but could not offer me the help i searched for until one day i came across testimonies on internet on how this DR IFADE has helped a lot of people around the country to enlarge their penis so I decided to give his herbal product a try, i emailed him via his email address (ifadesolutionspell31@gmail.com ) and he got back to me, he gave me some comforting words with his herbal product for Penis Enlargement, Within two weeks of me using it, i began to feel the enlargement, " and now it just 4 weeks of using his products my penis is about 8 inches longer, and now i can satisfy my wife, i was surprised when she said that she is satisfied with my performance in bed and i now have a large penis.thanks to DR IFADE for is herbal product. you can also reach him with email (ifadesolutionspell31@gmail.com ) OR VIA HIS WHATSAPP NUMBER [ +2349060120490 ].




      MILLER AARON,
      Hello everyone am MILLER AARON and i am from USA i am here to testify about an herbal doctor called Dr,IFADE I was heartbroken because i had very small penis,not nice to satisfy my wife and that always bring conflict between us and almost tear us apart, i have used so many product which doctors prescribe for me, but could not offer me the help i searched for until one day i came across testimonies on internet on how this DR IFADE has helped a lot of people around the country to enlarge their penis so I decided to give his herbal product a try, i emailed him via his email address (ifadesolutionspell31@gmail.com ) and he got back to me, he gave me some comforting words with his herbal product for Penis Enlargement, Within two weeks of me using it, i began to feel the enlargement, " and now it just 4 weeks of using his products my penis is about 8 inches longer, and now i can satisfy my wife, i was surprised when she said that she is satisfied with my performance in bed and i now have a large penis.thanks to DR IFADE for is herbal product. you can also reach him with email (ifadesolutionspell31@gmail.com ) OR VIA HIS WHATSAPP NUMBER [ +2349060120490 ].

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      My name is David Richardson from USA I want to share a testimony of how Dr Perfect herbal mixture cream saved me from shame and disgrace, my penis was a big problem to me as the size was really so embarrassing and I was also having weak erection problem. I can't make love to my wife and my penis was just too small, a full grown man like me having 3 inches penis and to worsen it I don't last long in sex I can't even last four minutes it was really a big shame to me. My wife was really tired of me because my sex life was very poor, she never enjoyed sex, I was always thinking and searching for solutions everywhere until when I saw a testimony of how Dr Perfect herbal mixture cream have been helping people regarding their sex life, so I decided to give him a try and to my greatest surprise in less than one week of taking the herbs my penis grow to 10 inches I couldn't believe my eyes and as I speak now my penis is now 10 inches long and I don't have weak erection anymore. I can make love to my wife longer in bed. And my marriage is now stable my wife is now enjoy me very well in bed. All thanks to Dr Perfect for enlarging my penis he indeed save my marriage. You can contact him at solutiontoallproblems1@gmail.com or you can add him up on WhatsApp +1(256) 251 3614. He also specializes in the following things
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      HOW DR PERFECT ENLARGEMENT CREAM HELP ME TO ENLARGE MY PENIS YOU CAN ADD HIM UP ON WHATSAPP +1(256) 251 3614

      My name is David Richardson from USA I want to share a testimony of how Dr Perfect herbal mixture cream saved me from shame and disgrace, my penis was a big problem to me as the size was really so embarrassing and I was also having weak erection problem. I can't make love to my wife and my penis was just too small, a full grown man like me having 3 inches penis and to worsen it I don't last long in sex I can't even last four minutes it was really a big shame to me. My wife was really tired of me because my sex life was very poor, she never enjoyed sex, I was always thinking and searching for solutions everywhere until when I saw a testimony of how Dr Perfect herbal mixture cream have been helping people regarding their sex life, so I decided to give him a try and to my greatest surprise in less than one week of taking the herbs my penis grow to 10 inches I couldn't believe my eyes and as I speak now my penis is now 10 inches long and I don't have weak erection anymore. I can make love to my wife longer in bed. And my marriage is now stable my wife is now enjoy me very well in bed. All thanks to Dr Perfect for enlarging my penis he indeed save my marriage. You can contact him at solutiontoallproblems1@gmail.com or you can add him up on WhatsApp +1(256) 251 3614. He also specializes in the following things
      Herpes virus
      Cancer
      Hsv
      Chronic venous disease
      and others

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    Hello my name is JORDAN OWENS i am here to say a big thank you to my doctor, DR BEN who helped me enlarge my penis.i have never had a happy relationship in my life because of my inability to perform well due to my small penis, due to frustration,i went online in search of solution to ending my predicament and then i came across testimony on how DR BEN has helped a lot of people so i decided to give this so called DR BEN a try so i contacted him and he promised to help me with penis enlargement,i doubted at first but i decided give him a trial then he sent me the product which i used according to his prescription and in less than a week,i saw changes in my penis and it grow to the size i wanted and since then i am now a happy man and no lady complains again about my penis.if you also need the services of this DR ,you can contact him on his email.voodoospelltemple80@gmail.com or his whatsapp is +2348140111921

    ReplyDelete
  7. Hello my name is JORDAN OWENS i am here to say a big thank you to my doctor, DR BEN who helped me enlarge my penis.i have never had a happy relationship in my life because of my inability to perform well due to my small penis, due to frustration,i went online in search of solution to ending my predicament and then i came across testimony on how DR BEN has helped a lot of people so i decided to give this so called DR BEN a try so i contacted him and he promised to help me with penis enlargement,i doubted at first but i decided give him a trial then he sent me the product which i used according to his prescription and in less than a week,i saw changes in my penis and it grow to the size i wanted and since then i am now a happy man and no lady complains again about my penis.if you also need the services of this DR ,you can contact him on his email.voodoospelltemple80@gmail.com or his whatsapp is +2348140111921



    Hello my name is JORDAN OWENS i am here to say a big thank you to my doctor, DR BEN who helped me enlarge my penis.i have never had a happy relationship in my life because of my inability to perform well due to my small penis, due to frustration,i went online in search of solution to ending my predicament and then i came across testimony on how DR BEN has helped a lot of people so i decided to give this so called DR BEN a try so i contacted him and he promised to help me with penis enlargement,i doubted at first but i decided give him a trial then he sent me the product which i used according to his prescription and in less than a week,i saw changes in my penis and it grow to the size i wanted and since then i am now a happy man and no lady complains again about my penis.if you also need the services of this DR ,you can contact him on his email.voodoospelltemple80@gmail.com or his whatsapp is +2348140111921

    ReplyDelete

  8. MILLER AARON,
    Hello everyone am MILLER AARON and i am from USA i am here to testify about an herbal doctor called Dr,IFADE I was heartbroken because i had very small penis,not nice to satisfy my wife and that always bring conflict between us and almost tear us apart, i have used so many product which doctors prescribe for me, but could not offer me the help i searched for until one day i came across testimonies on internet on how this DR IFADE has helped a lot of people around the country to enlarge their penis so I decided to give his herbal product a try, i emailed him via his email address (ifadesolutionspell31@gmail.com ) and he got back to me, he gave me some comforting words with his herbal product for Penis Enlargement, Within two weeks of me using it, i began to feel the enlargement, " and now it just 4 weeks of using his products my penis is about 8 inches longer, and now i can satisfy my wife, i was surprised when she said that she is satisfied with my performance in bed and i now have a large penis.thanks to DR IFADE for is herbal product. you can also reach him with email (ifadesolutionspell31@gmail.com ) OR VIA HIS WHATSAPP NUMBER [ +2349060120490 ].



    MILLER AARON,
    Hello everyone am MILLER AARON and i am from USA i am here to testify about an herbal doctor called Dr,IFADE I was heartbroken because i had very small penis,not nice to satisfy my wife and that always bring conflict between us and almost tear us apart, i have used so many product which doctors prescribe for me, but could not offer me the help i searched for until one day i came across testimonies on internet on how this DR IFADE has helped a lot of people around the country to enlarge their penis so I decided to give his herbal product a try, i emailed him via his email address (ifadesolutionspell31@gmail.com ) and he got back to me, he gave me some comforting words with his herbal product for Penis Enlargement, Within two weeks of me using it, i began to feel the enlargement, " and now it just 4 weeks of using his products my penis is about 8 inches longer, and now i can satisfy my wife, i was surprised when she said that she is satisfied with my performance in bed and i now have a large penis.thanks to DR IFADE for is herbal product. you can also reach him with email (ifadesolutionspell31@gmail.com ) OR VIA HIS WHATSAPP NUMBER [ +2349060120490 ].

    ReplyDelete

  9. MILLER AARON,
    Hello everyone am MILLER AARON and i am from USA i am here to testify about an herbal doctor called Dr,IFADE I was heartbroken because i had very small penis,not nice to satisfy my wife and that always bring conflict between us and almost tear us apart, i have used so many product which doctors prescribe for me, but could not offer me the help i searched for until one day i came across testimonies on internet on how this DR IFADE has helped a lot of people around the country to enlarge their penis so I decided to give his herbal product a try, i emailed him via his email address (ifadesolutionspell31@gmail.com ) and he got back to me, he gave me some comforting words with his herbal product for Penis Enlargement, Within two weeks of me using it, i began to feel the enlargement, " and now it just 4 weeks of using his products my penis is about 8 inches longer, and now i can satisfy my wife, i was surprised when she said that she is satisfied with my performance in bed and i now have a large penis.thanks to DR IFADE for is herbal product. you can also reach him with email (ifadesolutionspell31@gmail.com ) OR VIA HIS WHATSAPP NUMBER [ +2349060120490 ].





    MILLER AARON,
    Hello everyone am MILLER AARON and i am from USA i am here to testify about an herbal doctor called Dr,IFADE I was heartbroken because i had very small penis,not nice to satisfy my wife and that always bring conflict between us and almost tear us apart, i have used so many product which doctors prescribe for me, but could not offer me the help i searched for until one day i came across testimonies on internet on how this DR IFADE has helped a lot of people around the country to enlarge their penis so I decided to give his herbal product a try, i emailed him via his email address (ifadesolutionspell31@gmail.com ) and he got back to me, he gave me some comforting words with his herbal product for Penis Enlargement, Within two weeks of me using it, i began to feel the enlargement, " and now it just 4 weeks of using his products my penis is about 8 inches longer, and now i can satisfy my wife, i was surprised when she said that she is satisfied with my performance in bed and i now have a large penis.thanks to DR IFADE for is herbal product. you can also reach him with email (ifadesolutionspell31@gmail.com ) OR VIA HIS WHATSAPP NUMBER [ +2349060120490 ].

    ReplyDelete

  10. MILLER AARON,
    Hello everyone am MILLER AARON and i am from USA i am here to testify about an herbal doctor called Dr,IFADE I was heartbroken because i had very small penis,not nice to satisfy my wife and that always bring conflict between us and almost tear us apart, i have used so many product which doctors prescribe for me, but could not offer me the help i searched for until one day i came across testimonies on internet on how this DR IFADE has helped a lot of people around the country to enlarge their penis so I decided to give his herbal product a try, i emailed him via his email address (ifadesolutionspell31@gmail.com ) and he got back to me, he gave me some comforting words with his herbal product for Penis Enlargement, Within two weeks of me using it, i began to feel the enlargement, " and now it just 4 weeks of using his products my penis is about 8 inches longer, and now i can satisfy my wife, i was surprised when she said that she is satisfied with my performance in bed and i now have a large penis.thanks to DR IFADE for is herbal product. you can also reach him with email (ifadesolutionspell31@gmail.com ) OR VIA HIS WHATSAPP NUMBER [ +2349060120490 ].






    MILLER AARON,
    Hello everyone am MILLER AARON and i am from USA i am here to testify about an herbal doctor called Dr,IFADE I was heartbroken because i had very small penis,not nice to satisfy my wife and that always bring conflict between us and almost tear us apart, i have used so many product which doctors prescribe for me, but could not offer me the help i searched for until one day i came across testimonies on internet on how this DR IFADE has helped a lot of people around the country to enlarge their penis so I decided to give his herbal product a try, i emailed him via his email address (ifadesolutionspell31@gmail.com ) and he got back to me, he gave me some comforting words with his herbal product for Penis Enlargement, Within two weeks of me using it, i began to feel the enlargement, " and now it just 4 weeks of using his products my penis is about 8 inches longer, and now i can satisfy my wife, i was surprised when she said that she is satisfied with my performance in bed and i now have a large penis.thanks to DR IFADE for is herbal product. you can also reach him with email (ifadesolutionspell31@gmail.com ) OR VIA HIS WHATSAPP NUMBER [ +2349060120490 ].

    ReplyDelete

  11. MILLER AARON,
    Hello everyone am MILLER AARON and i am from USA i am here to testify about an herbal doctor called Dr,IFADE I was heartbroken because i had very small penis,not nice to satisfy my wife and that always bring conflict between us and almost tear us apart, i have used so many product which doctors prescribe for me, but could not offer me the help i searched for until one day i came across testimonies on internet on how this DR IFADE has helped a lot of people around the country to enlarge their penis so I decided to give his herbal product a try, i emailed him via his email address (ifadesolutionspell31@gmail.com ) and he got back to me, he gave me some comforting words with his herbal product for Penis Enlargement, Within two weeks of me using it, i began to feel the enlargement, " and now it just 4 weeks of using his products my penis is about 8 inches longer, and now i can satisfy my wife, i was surprised when she said that she is satisfied with my performance in bed and i now have a large penis.thanks to DR IFADE for is herbal product. you can also reach him with email (ifadesolutionspell31@gmail.com ) OR VIA HIS WHATSAPP NUMBER [ +2349060120490 ].




    MILLER AARON,
    Hello everyone am MILLER AARON and i am from USA i am here to testify about an herbal doctor called Dr,IFADE I was heartbroken because i had very small penis,not nice to satisfy my wife and that always bring conflict between us and almost tear us apart, i have used so many product which doctors prescribe for me, but could not offer me the help i searched for until one day i came across testimonies on internet on how this DR IFADE has helped a lot of people around the country to enlarge their penis so I decided to give his herbal product a try, i emailed him via his email address (ifadesolutionspell31@gmail.com ) and he got back to me, he gave me some comforting words with his herbal product for Penis Enlargement, Within two weeks of me using it, i began to feel the enlargement, " and now it just 4 weeks of using his products my penis is about 8 inches longer, and now i can satisfy my wife, i was surprised when she said that she is satisfied with my performance in bed and i now have a large penis.thanks to DR IFADE for is herbal product. you can also reach him with email (ifadesolutionspell31@gmail.com ) OR VIA HIS WHATSAPP NUMBER [ +2349060120490 ].

    ReplyDelete

  12. MILLER AARON,
    Hello everyone am MILLER AARON and i am from USA i am here to testify about an herbal doctor called Dr,IFADE I was heartbroken because i had very small penis,not nice to satisfy my wife and that always bring conflict between us and almost tear us apart, i have used so many product which doctors prescribe for me, but could not offer me the help i searched for until one day i came across testimonies on internet on how this DR IFADE has helped a lot of people around the country to enlarge their penis so I decided to give his herbal product a try, i emailed him via his email address (ifadesolutionspell31@gmail.com ) and he got back to me, he gave me some comforting words with his herbal product for Penis Enlargement, Within two weeks of me using it, i began to feel the enlargement, " and now it just 4 weeks of using his products my penis is about 8 inches longer, and now i can satisfy my wife, i was surprised when she said that she is satisfied with my performance in bed and i now have a large penis.thanks to DR IFADE for is herbal product. you can also reach him with email (ifadesolutionspell31@gmail.com ) OR VIA HIS WHATSAPP NUMBER [ +2349060120490 ].



    MILLER AARON,
    Hello everyone am MILLER AARON and i am from USA i am here to testify about an herbal doctor called Dr,IFADE I was heartbroken because i had very small penis,not nice to satisfy my wife and that always bring conflict between us and almost tear us apart, i have used so many product which doctors prescribe for me, but could not offer me the help i searched for until one day i came across testimonies on internet on how this DR IFADE has helped a lot of people around the country to enlarge their penis so I decided to give his herbal product a try, i emailed him via his email address (ifadesolutionspell31@gmail.com ) and he got back to me, he gave me some comforting words with his herbal product for Penis Enlargement, Within two weeks of me using it, i began to feel the enlargement, " and now it just 4 weeks of using his products my penis is about 8 inches longer, and now i can satisfy my wife, i was surprised when she said that she is satisfied with my performance in bed and i now have a large penis.thanks to DR IFADE for is herbal product. you can also reach him with email (ifadesolutionspell31@gmail.com ) OR VIA HIS WHATSAPP NUMBER [ +2349060120490 ].

    ReplyDelete
    Replies

    1. MILLER AARON,
      Hello everyone am MILLER AARON and i am from USA i am here to testify about an herbal doctor called Dr,IFADE I was heartbroken because i had very small penis,not nice to satisfy my wife and that always bring conflict between us and almost tear us apart, i have used so many product which doctors prescribe for me, but could not offer me the help i searched for until one day i came across testimonies on internet on how this DR IFADE has helped a lot of people around the country to enlarge their penis so I decided to give his herbal product a try, i emailed him via his email address (ifadesolutionspell31@gmail.com ) and he got back to me, he gave me some comforting words with his herbal product for Penis Enlargement, Within two weeks of me using it, i began to feel the enlargement, " and now it just 4 weeks of using his products my penis is about 8 inches longer, and now i can satisfy my wife, i was surprised when she said that she is satisfied with my performance in bed and i now have a large penis.thanks to DR IFADE for is herbal product. you can also reach him with email (ifadesolutionspell31@gmail.com ) OR VIA HIS WHATSAPP NUMBER [ +2349060120490 ].




      MILLER AARON,
      Hello everyone am MILLER AARON and i am from USA i am here to testify about an herbal doctor called Dr,IFADE I was heartbroken because i had very small penis,not nice to satisfy my wife and that always bring conflict between us and almost tear us apart, i have used so many product which doctors prescribe for me, but could not offer me the help i searched for until one day i came across testimonies on internet on how this DR IFADE has helped a lot of people around the country to enlarge their penis so I decided to give his herbal product a try, i emailed him via his email address (ifadesolutionspell31@gmail.com ) and he got back to me, he gave me some comforting words with his herbal product for Penis Enlargement, Within two weeks of me using it, i began to feel the enlargement, " and now it just 4 weeks of using his products my penis is about 8 inches longer, and now i can satisfy my wife, i was surprised when she said that she is satisfied with my performance in bed and i now have a large penis.thanks to DR IFADE for is herbal product. you can also reach him with email (ifadesolutionspell31@gmail.com ) OR VIA HIS WHATSAPP NUMBER [ +2349060120490 ].

      Delete
  13. Hello everyone. I was heartbroken because i had very small penis, not nice to satisfy a woman, i had so many relationship called off because of my situation, i have used so many product which i found online but none could offer me the help i searched for. i saw some few comments about this doctor called Dr. OMOHAN and I decided to email him on: dromohanherbalmedicine@gmail.com so I decided to give his herbal product a try. i emailed him and he got back to me, he gave me some comforting words with his herbal cream for Penis Enlargement, Within 1 week of it, i began to feel the enlargement of my penis, " and now it just 2 weeks of using his products my penis is about 9 inches longer and strong. I'm so happy..feel free to contact DR omohan on his Email: dromohanherbalmedicine@gmail.com or you can also call him on the whatsapp contact +2348164816038

    ReplyDelete

  14. HIP/BUM ENLARGEMENT BREAST ENLARGEMENT BREAST LIFT & REDUCTION PENILE/PENIS ENLARGEMENT GENERAL BODY SLIMMING HIPS & THIGH REDUCTION YOU CAN CONTACT ON HIS email.voodoospelltemple80@gmail.com OR HIS whatsapp is +2348140111921

    Hello my name is JORDAN OWENS i am here to say a big thank you to my doctor, DR BEN who helped me enlarge my penis.i have never had a happy relationship in my life because of my inability to perform well due to my small penis, due to frustration,i went online in search of solution to ending my predicament and then i came across testimony on how DR BEN has helped a lot of people so i decided to give this so called DR BEN a try so i contacted him and he promised to help me with penis enlargement,i doubted at first but i decided give him a trial then he sent me the product which i used according to his prescription and in less than a week,i saw changes in my penis and it grow to the size i wanted and since then i am now a happy man and no lady complains again about my penis.if you also need the services of this DR ,you can contact him on his email.voodoospelltemple80@gmail.com or his whatsapp is +2348140111921





    HIP/BUM ENLARGEMENT BREAST ENLARGEMENT BREAST LIFT & REDUCTION PENILE/PENIS ENLARGEMENT GENERAL BODY SLIMMING HIPS & THIGH REDUCTION YOU CAN CONTACT ON HIS email.voodoospelltemple80@gmail.com OR HIS whatsapp is +2348140111921

    Hello my name is JORDAN OWENS i am here to say a big thank you to my doctor, DR BEN who helped me enlarge my penis.i have never had a happy relationship in my life because of my inability to perform well due to my small penis, due to frustration,i went online in search of solution to ending my predicament and then i came across testimony on how DR BEN has helped a lot of people so i decided to give this so called DR BEN a try so i contacted him and he promised to help me with penis enlargement,i doubted at first but i decided give him a trial then he sent me the product which i used according to his prescription and in less than a week,i saw changes in my penis and it grow to the size i wanted and since then i am now a happy man and no lady complains again about my penis.if you also need the services of this DR ,you can contact him on his email.voodoospelltemple80@gmail.com or his whatsapp is +2348140111921

    ReplyDelete
  15. HOW DR PERFECT ENLARGEMENT CREAM HELP ME TO ENLARGE MY PENIS YOU CAN ADD HIM UP ON WHATSAPP +1(256) 251 3614

    My name is David Richardson from USA I want to share a testimony of how Dr Perfect herbal mixture cream saved me from shame and disgrace, my penis was a big problem to me as the size was really so embarrassing and I was also having weak erection problem. I can't make love to my wife and my penis was just too small, a full grown man like me having 3 inches penis and to worsen it I don't last long in sex I can't even last four minutes it was really a big shame to me. My wife was really tired of me because my sex life was very poor, she never enjoyed sex, I was always thinking and searching for solutions everywhere until when I saw a testimony of how Dr Perfect herbal mixture cream have been helping people regarding their sex life, so I decided to give him a try and to my greatest surprise in less than one week of taking the herbs my penis grow to 10 inches I couldn't believe my eyes and as I speak now my penis is now 10 inches long and I don't have weak erection anymore. I can make love to my wife longer in bed. And my marriage is now stable my wife is now enjoy me very well in bed. All thanks to Dr Perfect for enlarging my penis he indeed save my marriage. You can contact him at solutiontoallproblems1@gmail.com or you can add him up on WhatsApp +1(256) 251 3614. He also specializes in the following things
    Herpes virus
    Cancer
    Hsv
    Chronic venous disease
    and others

    ReplyDelete
  16. HOW DR PERFECT ENLARGEMENT CREAM HELP ME TO ENLARGE MY PENIS YOU CAN ADD HIM UP ON WHATSAPP +1(256) 251 3614

    My name is David Richardson from USA I want to share a testimony of how Dr Perfect herbal mixture cream saved me from shame and disgrace, my penis was a big problem to me as the size was really so embarrassing and I was also having weak erection problem. I can't make love to my wife and my penis was just too small, a full grown man like me having 3 inches penis and to worsen it I don't last long in sex I can't even last four minutes it was really a big shame to me. My wife was really tired of me because my sex life was very poor, she never enjoyed sex, I was always thinking and searching for solutions everywhere until when I saw a testimony of how Dr Perfect herbal mixture cream have been helping people regarding their sex life, so I decided to give him a try and to my greatest surprise in less than one week of taking the herbs my penis grow to 10 inches I couldn't believe my eyes and as I speak now my penis is now 10 inches long and I don't have weak erection anymore. I can make love to my wife longer in bed. And my marriage is now stable my wife is now enjoy me very well in bed. All thanks to Dr Perfect for enlarging my penis he indeed save my marriage. You can contact him at solutiontoallproblems1@gmail.com or you can add him up on WhatsApp +1(256) 251 3614. He also specializes in the following things
    Herpes virus
    Cancer
    Hsv
    Chronic venous disease
    and others

    ReplyDelete
  17. HOW DR PERFECT ENLARGEMENT CREAM HELP ME TO ENLARGE MY PENIS YOU CAN ADD HIM UP ON WHATSAPP +1(256) 251 3614

    My name is David Richardson from USA I want to share a testimony of how Dr Perfect herbal mixture cream saved me from shame and disgrace, my penis was a big problem to me as the size was really so embarrassing and I was also having weak erection problem. I can't make love to my wife and my penis was just too small, a full grown man like me having 3 inches penis and to worsen it I don't last long in sex I can't even last four minutes it was really a big shame to me. My wife was really tired of me because my sex life was very poor, she never enjoyed sex, I was always thinking and searching for solutions everywhere until when I saw a testimony of how Dr Perfect herbal mixture cream have been helping people regarding their sex life, so I decided to give him a try and to my greatest surprise in less than one week of taking the herbs my penis grow to 10 inches I couldn't believe my eyes and as I speak now my penis is now 10 inches long and I don't have weak erection anymore. I can make love to my wife longer in bed. And my marriage is now stable my wife is now enjoy me very well in bed. All thanks to Dr Perfect for enlarging my penis he indeed save my marriage. You can contact him at solutiontoallproblems1@gmail.com or you can add him up on WhatsApp +1(256) 251 3614. He also specializes in the following things
    Herpes virus
    Cancer
    Hsv
    Chronic venous disease
    and others

    ReplyDelete
  18. Hello everyone, am very happy to share this little awesome testimony about Dr osemuhah a great herbal doctor who help me enlarge my penis size from 4.2 cm to 9.4 cm longer with his herbal cream mixture, my girlfriend is now so amazed with the autonomous size of my penis , if you are also in need of help on how to enlarge your penis size to become bigger and stronger I adverse you to contact Dr osemuhau today on his email you can contact him on +2348168714427 or whatsapp his number +2348168714427 because he is one of the best herbal doctor that i can only show you up to, if your penis is 4.2 cm and want to get it reach 9.4 cm within three weeks i Dr osemuhau is also specialized on breast and boobs enlargement i advise you to contact him for help you can all emaill him on drosemuhau@gmail.com

    ReplyDelete
  19. Hello everyone I was heartbroken because i had very small penis, not nice to satisfy a woman, i had so many relationship called off because of my situation, i have used so many product which i found online but none could offer me the help i searched for. i saw some few comments about this specialist called Dr Osemuhau and decided to email him on so I decided to give his herbal product a try. i emailed him and he got back to me, he gave me some comforting words with his herbal pills for Penis t, Enlargement Within 1 week of it, i began to feel the enlargement of my penis, and now it just 1 weeks of using his products my penis is about 9 inches longer and am so happy feel free to contact DR Osemuhauon email address drosemuhau@gmail. com or whatsapp him this number +2348168714427 for more info you can call him +2348168714427

    ReplyDelete
  20. I was diagnose with hpv virus for 5years i broke up with my boyfriend because i contracted the virus from him, luckily i found a herbalist name Dr. onokun everyone testify good of his natural treatment i picked up his address and contacted him. he truly treated me with natural herbs in a week and i got cured. i share this post because ever since i got this treatment I'm perfectly ok with my health. i contacted him through this email.. dronokunherbalcure@gmail.com

    ReplyDelete
  21. hello everyone here i want to tell the whole world about DR AKIOYA herbal mixture product ...Dr AKIOYA penis enlargement herbal product in Africa.This is the only Male Penis Enlargement product has been used by men around the world like USA,CANADA,AUSTRALIA,BELGIUM,SWEDEN,GERMANY,UK,SINGAPORE,MALAYSIA AND SO MANY MORE supplement that has been PROVEN to-enlarge your penis – safely, quickly, and importantly – PERMANENTLY.Full DR AKIOYA Penis Enlargement product when used will Increase in penis length by 1-5 inches Increase in penis width by 20%helps in preventing Premature Ejaculation.Achieved longer, rock hard erections All gains in penis length and width are 100% permanent Full AKIOYA Penis Enlargement product is also:100% Herbal, 100% Safest with no side effect and its of two types I have the one for enlargement and for reduction and your advised to use it by message 100% Satisfaction and Money Back Guarantee. DR.AKIOYA, About my products i have herbal product and oil 100% Permanent Guaranteed resulting it on your body where you feel you want to reduce or enlarge which will help you to be strong and you get the desirable size you want-within 3-5 days and when you get your desirable size you are advised to stop using it and the results you gain will remain permanent We also do deliveries all over AFRICA, and worldwide so i would like to know first when do you need the product.for more information call or whatsapp Dr.AKIOYA +2348105257464 or call +2348105257464 email DrAkioya17spellhome@gmail.com
    note DR AKIOYA also have herbal medicines to problems like
    PENIS ENLARGEMENT
    ERECTILE DYSFUNCTION
    DIABETES type 1 and type 2
    HERPES GENITAL WART
    LOW SPERM COUNT
    WEAK ERECTION
    BREAST ENLARGEMENT
    PROSTRATE CANCER
    HIV/AIDS
    SPELL OF ALL KINDS LIKE EX BACK,CANCEL DIVORCE,BREAK UP SPELL ,PREGNANCY SPELL,PROMOTION SPELL,JOB SPELL
    ALS
    HPV 123
    PILE
    ASTHMA
    HEART FAILURE
    PREMATURE EJACULATION
    HEPATITIS A,B,C AND MANY MORE
    THANKS

    ReplyDelete
  22. Hello everyone I was heartbroken because i had very small penis, not nice to satisfy my woman, i had so many relationship called off because of my situation, i have used so many product which i found online but none could offer me the help i searched for. i saw some few comments about this specialist called Dr Osagie and decided to email him on so I decided to give his herbal product a try. i emailed him and he got back to me, he gave me some
    comforting words with his herbal pills for Penis t, Enlargement Within 1 week of it, i began to feel the enlargement of my penis, and now it just 1 weeks of using his products my penis is about 9 inches
    longer and am so happy feel free to contact DR Osagie on email address: drosagiesolutiontemple@gmail.com OR
    DROSAGIESOULTIONTEMPLE@YAHOO.COM or WhatsApp him /call +2347068398092 for more info you can call.

    ReplyDelete
  23. drfredspirituraltemple@yahoo.com)) my dear readers around the globe, it is a great privilege to tell you about this great man who helped me over come the tragedy in my relationship, and how his herbal medicine help me too. My relationship became so complicated to a stage that I was scared of losing my wife to another, lasting long in bed was a problem and I knew deep down in my that my wife was not happy about it. Sometimes when I asked for sex the way she would act before the sex I noticed it was because I was not satisfying her, when she needed it more I hard already come and it was not the best. So I needed to find solution that was how I came in contact with DR FRED he really changed my sex life and ever since then life has been fun because my wife now love me more than she used to, all thanks to DR FRED for this great thing he did for me.. If you ever need help of any kind sickness like DIABETES.. HERPES..BREAST ENLARGEMENT.. you can visit DR FRED temple for solution ((drfredspirituraltemple@gmail.com)) or what's app +2348158839763..

    ReplyDelete
  24. Hello everyone, am very happy to share this little awesome testimony about Dr olu a great herbal doctor who help me enlarge my penis size.3.2 cm to 8.3 cm longer with his herbal cream mixture, my girlfriend is now so amazed with the autonomous size of my penis , if you you are also in need of help on how to enlarge your penis to become bigger and stronger I adverse you to contact Dr on his email (drolusolutionhome@gmail.com) ) you or contact on whatsapp number +2348140654426 because he is one of the best herbal doctor that i can only show you up to, if your penis is 4.2 cm and want to get it reach 9.2 cm within three weeks i Dr olu is also specialized on obey m breast and boobs enlargement i advise you to contact him for help

    ReplyDelete
  25. I am Miss alisha,From USA. I will start by saying to all that have experience heart break and also cant do with out there lover should please stop here and read up my story, So as you will know how to go solving or getting your ex back from this spell caster..AND AGAIN I WILL WANT TO ALSO TELL ALL THAT THIS SPELL CASTER I WILL WANT TO TELL THE WHOLE WORLD ABOUT IS HARMLESS AND DO NOT HAVE ANY SIDE EFFECT, BUT TO RESTORE AND GIVE YOU BACK WHAT YOU DESERVE, COS WHEN I MEET WITH THIS SPELL CASTER THAT WAS INTRODUCED TO ME BY THE WIFE OF MY BOSS IN MY WORKING PLACE, HE MADE IT CLEAR THAT HE CAN CAST SPELL ON SO MANY OTHER PROBLEMS EXCEPT IN GETTING YOUR EX OR MAKING YOUR LOVER TO LOVE YOU MORE THAT WILL SUITE YOU. Last year December, My lover was cheating on me and was not also give me the attention that a man should give to a woman,And really that was troubling my mind and tearing my heart apart to the extent that i was not concentrating in the office the way i use to before the break up by my lover.And before that incident,I always see how my boss use to love his wife so much. I was bringing to think that i was not doing the right thing to him that will make him love me forever,So i really gathered my courage and went to my boss wife office to ask her the secret that made her husband love her so dearly,In the first place she refused in telling me,She asked me why i am asking her such a question,That if is it not normal for every man to love his wife.I told her the reason that made me ask her about this question,That my lover started cheating on me lately,When i knelt down before her for her to see my seriousness in this issue that i went to ask her,She opened up to me by telling me that i should not tell anybody about what she want to tell me,The wife to my boss started to say to me that she used a very powerful spell on his husband to love her,And the spell that she used is harmless, But the spell is just to make him love her and never to look for any other woman except her. I QUICKLY ASK HER HOW DID SHE GET TO KNOW THIS GREAT,POWER,DURABLE AND PERFECT WORK SPELL CASTER,she said that a friend of hers also introduce her to him. Then i also ask her how i can meet with this spell caster.SHE SAID EVERYTHING TO ME,THAT THE NAME OF THIS SPELL CASTER IS Dr.AZEN .My next question to her was how can i get this wonderful spell caster,She said she is going to give me the email of the spell caster for me to contact him for my problem,Really she gave to me this spell caster email:[azentemple@gmail.com]or what'sapp +2349038299828. and i contacted him and explained all to him,And after every thing that needed to be done by the spell caster, In the next two days, My lover that hated me so much came to house begging for forgiveness and i was so glad that i have finally gotten my heart desire..I was so grateful to this spell caster for what he has done for my life.. So i made a promise to him that i will always come

    ReplyDelete
  26. I am Miss alisha,From USA. I will start by saying to all that have experience heart break and also cant do with out there lover should please stop here and read up my story, So as you will know how to go solving or getting your ex back from this spell caster..AND AGAIN I WILL WANT TO ALSO TELL ALL THAT THIS SPELL CASTER I WILL WANT TO TELL THE WHOLE WORLD ABOUT IS HARMLESS AND DO NOT HAVE ANY SIDE EFFECT, BUT TO RESTORE AND GIVE YOU BACK WHAT YOU DESERVE, COS WHEN I MEET WITH THIS SPELL CASTER THAT WAS INTRODUCED TO ME BY THE WIFE OF MY BOSS IN MY WORKING PLACE, HE MADE IT CLEAR THAT HE CAN CAST SPELL ON SO MANY OTHER PROBLEMS EXCEPT IN GETTING YOUR EX OR MAKING YOUR LOVER TO LOVE YOU MORE THAT WILL SUITE YOU. Last year December, My lover was cheating on me and was not also give me the attention that a man should give to a woman,And really that was troubling my mind and tearing my heart apart to the extent that i was not concentrating in the office the way i use to before the break up by my lover.And before that incident,I always see how my boss use to love his wife so much. I was bringing to think that i was not doing the right thing to him that will make him love me forever,So i really gathered my courage and went to my boss wife office to ask her the secret that made her husband love her so dearly,In the first place she refused in telling me,She asked me why i am asking her such a question,That if is it not normal for every man to love his wife.I told her the reason that made me ask her about this question,That my lover started cheating on me lately,When i knelt down before her for her to see my seriousness in this issue that i went to ask her,She opened up to me by telling me that i should not tell anybody about what she want to tell me,The wife to my boss started to say to me that she used a very powerful spell on his husband to love her,And the spell that she used is harmless, But the spell is just to make him love her and never to look for any other woman except her. I QUICKLY ASK HER HOW DID SHE GET TO KNOW THIS GREAT,POWER,DURABLE AND PERFECT WORK SPELL CASTER,she said that a friend of hers also introduce her to him. Then i also ask her how i can meet with this spell caster.SHE SAID EVERYTHING TO ME,THAT THE NAME OF THIS SPELL CASTER IS Dr.AZEN .My next question to her was how can i get this wonderful spell caster,She said she is going to give me the email of the spell caster for me to contact him for my problem,Really she gave to me this spell caster email:[azentemple@gmail.com]or what'sapp +2349038299828. and i contacted him and explained all to him,And after every thing that needed to be done by the spell caster, In the next two days, My lover that hated me so much came to house begging for forgiveness and i was so glad that i have finally gotten my heart desire..I was so grateful to this spell caster for what he has done for my life.. So i made a promise to him that i will always come

    ReplyDelete
  27. I was diagnose of Chronic Obstructive Pulmonary Disease (COPD) 2 years ago, my family doctor told me there is no cure but it can only be controled. Ever since then i have been running heather scepter looking for a solution to my problem because i was going to lose my Job if i dont get better, until i ran into this online testimony of Mrs Alicia who have been cured of COPD by this herbal clinic in Africa (Astoria Herbal Clinic), i immediately contacted them via their email (azentemple@gmailcom), to God be thy glory i bought this COPD herbal remedy and was cured within 3 weeks of usage, at last this is a break through for all COPD patients contact this herbal clinic via their email ( azentemple@gmailcom) or whasapp +2349038299828 He also have the herb to cure:
    (1) ALS,
    (2) DIABETES,
    (3) HIV&AIDS,
    (4) URINARY TRACT INFECTION,
    (5) CANCER,
    (6) HERPES.

    ReplyDelete
  28. I was diagnose of Chronic Obstructive Pulmonary Disease (COPD) 2 years ago, my family doctor told me there is no cure but it can only be controled. Ever since then i have been running heather scepter looking for a solution to my problem because i was going to lose my Job if i dont get better, until i ran into this online testimony of Mrs Alicia who have been cured of COPD by this herbal clinic in Africa (Astoria Herbal Clinic), i immediately contacted them via their email (azentemple@gmailcom), to God be thy glory i bought this COPD herbal remedy and was cured within 3 weeks of usage, at last this is a break through for all COPD patients contact this herbal clinic via their email ( azentemple@gmailcom) or whasapp +2349038299828 He also have the herb to cure:
    (1) ALS,
    (2) DIABETES,
    (3) HIV&AIDS,
    (4) URINARY TRACT INFECTION,
    (5) CANCER,
    (6) HERPES.

    ReplyDelete
  29. I'm 15 years old. I was born with HIV my mother passed away because of the HIV infection And I regret why i never met Dr Itua he could have cured my mum for me because as a single mother it was very hard for my mother I came across Dr itua healing words online about how he cure different disease in different races diseases like HIV/Aids Herpes,Parkison,Asthma,Copd,Epilepsy,Shingles,Cold Sore,Infertility, Chronic Fatigues Syndrome,Fibromyalgia, Diabetes Hepatitis even Cancer I was so excited but frighten at same time because I haven't come across such thing article online then I contacted Dr Itua on Mail drituaherbalcenter@gmail.com I also chat with him on what's app +2348149277967 he tells me how it works then I tell him I want to proceed I paid him so swiftly Colorado post office I receive my herbal medicine within 4/5 working days he gave me guild lines to follow and here am I living healthy again can imagine how god use men to manifest his works am I writing in all articles online to spread the god work of Dr Itua Herbal Medicine,He's a Great Man.

    ReplyDelete
  30. Hello viewers around the Globe, i had a very
    small penis, about 2.5 inches soft and 4
    inches hard not nice enough
    to satisfy a woman, i have been in so many
    relationship, but cut off
    because of my situation, i have used so
    many product which doctors
    prescribe for me, but none could offer me
    the help i searched for. i
    saw some few comments on the internet
    about this specialist called Dr,
    OSAGIE and i decided to contact him on his
    website i saw on the
    internet Email: his email: (drosagiesolutiontemple@gmail.com
    I decided to give his
    herbal product a try. i emailed him and he
    got back to me, he gave me
    some comforting words with his herbal
    medicine for Penis Enlargement,
    Within 2 week of it, i began to feel the
    enlargement of my penis, and now it just 4 weeks of using his
    products my penis is about 8
    inches longer, and i had to settle out with
    my Ex wife Ella, i
    was surprised when she said that she is
    satisfied with my sex and i
    have got a large penis. Am so happy,
    thanks to Dr OSAGIE I also learn
    that Dr OSAGIE a
    weak ejaculation, small breast_hips_bums
    Email: his email:
    (drosagiesolutiontemple@gmail.com OR
    DROSAGIESOULTIONTEMPLE@YAHOO.COM )

    Whatsappnumber +2347030465649
    THANK YOU MY DR

    ReplyDelete
  31. Hello viewers around the Globe, i had a very
    small penis, about 2.5 inches soft and 4
    inches hard not nice enough
    to satisfy a woman, i have been in so many
    relationship, but cut off
    because of my situation, i have used so
    many product which doctors
    prescribe for me, but none could offer me
    the help i searched for. i
    saw some few comments on the internet
    about this specialist called Dr,
    OSAGIE and i decided to contact him on his
    website i saw on the
    internet Email: his email: (drosagiesolutiontemple@gmail.com
    I decided to give his
    herbal product a try. i emailed him and he
    got back to me, he gave me
    some comforting words with his herbal
    medicine for Penis Enlargement,
    Within 2 week of it, i began to feel the
    enlargement of my penis, and now it just 4 weeks of using his
    products my penis is about 8
    inches longer, and i had to settle out with
    my Ex wife Ella, i
    was surprised when she said that she is
    satisfied with my sex and i
    have got a large penis. Am so happy,
    thanks to Dr OSAGIE I also learn
    that Dr OSAGIE a
    weak ejaculation, small breast_hips_bums
    Email: his email:
    (drosagiesolutiontemple@gmail.com OR
    DROSAGIESOULTIONTEMPLE@YAHOO.COM )

    Whatsappnumber +2347030465649
    THANK YOU MY DR

    ReplyDelete
  32. My name is Clifford John from USA taxes, I want to share a testimony of how Dr_Ogodo1 herbal mixture cream saves me from shame and disgrace, my penis was a big problem to me as the size was really so embarrassing,and i was also having weak erection problem. I can't make love to my wife and my penis was just too small a full grown man like me having 4 inches penis and to worsen it i don't last in sex i can't even last two minutes it was really a thing of shame to me. My wife was really tired of me because my sex life was very poor,she never enjoyed sex,i was always thinking and searching for solutions everywhere until when i saw a testimony of how Dr_Ogodo1 herbal mixture cream have been helping people regarding their sex life, so i decided to give him a try and to my greatest surprise in less than one week of taking the herbs my penis grow to 8 inches i couldn't believe my eyes and as i speak now my penis is now 8 inches and i do not have week erection again. I can make love to my wife longer in bed. And my marriage is now stable,my wife now enjoy me very well in bed.
    * He can also bring back your Ex
    *Love spell
    * Herpes virus diseases
    *Diabetes
    *Aid virus
    *STD/HSV
    *Cancer/typhoid E.t.c you contact him through the mail. Ogodoherbalhomesolution@gmail.com
    You can also WhatsApp him on +2349044680467

    ReplyDelete
  33. Am sharing this testimony to partners suffering in their relationships because there is an enduring solution. My husband left me and our 4 kids for another woman for 1 year. I tried to be strong just for my kids but I could not control the pains that torment my heart. I was hurt and confused. I needed a help, so i did a research on the internet and came across a site where I saw that Dr. Godday a spell caster,who can help get lot lovers back within few hours I contacted him and he did a special prayer and spells for me. To my surprises, after few days, my husband came back home. That was how we reunited again and there was a lot of love, joy and peace in the family. You can as well contact Dr. Godday, a powerful spell-caster for solutions on his contact Email: goddayspiritualhome@gmail.com Whats app only +1{919}4956404

    ReplyDelete
  34. How I got an xmas loan

    My name is Michelle Holt residing in Louisville Kentucky, I want to say a very big thank you to Mr Richard Jame Dyson of Jennard Investments Limited for granting me a xmas loan of $42,000 at 3% interest rate through their xmas loan program that is current running. You too can get your xmas and business loan from them as well. Contact them on email: jennardinvestmentslimited@outlook.com & cell phone number +1(484) 292–4513.

    ReplyDelete
  35. How I got an xmas loan

    My name is Michelle Holt residing in Louisville Kentucky, I want to say a very big thank you to Mr Richard Jame Dyson of Jennard Investments Limited for granting me a xmas loan of $42,000 at 3% interest rate through their xmas loan program that is current running. You too can get your xmas and business loan from them as well. Contact them on email: jennardinvestmentslimited@outlook.com & cell phone number +1(484) 292–4513..

    ReplyDelete
  36. After 8 years in marriage with my husband with 4 kids, my husband started acting weird and going out with other ladies and showed me cold love, on several occasions he threatens to divorce me if I dare question him about his affair with other ladies, I was totally devastated and confused until an old friend of mine told me about a spell caster on the internet called Dr. Silver who help people with and marriage problem by the powers of love spells, at first I doubted if such thing ever exists but decided to give it a try, when I contact him, he helped me cast a love spell and within 24 hours my husband came back to me and started apologizing, now he has stopped going out with other ladies and his with me for good and for real. Contact this great love spell caster for your relationship or marriage problem to be solved today via: drsilverhealingtemple@gmail.com

    ReplyDelete
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    ReplyDelete