Diseases Conditions Questions and Answers
What could end in an elevated hemoglobin count?
Answer: Elevated Hemoglobin: Risks & Symptoms
Hemoglobin is a protein-based component of red blood cell which primary role is transferring oxygen from the lungs to the rest of the body. Although not lots empire know around this, hemoglobin is in actuality the principle red blood cell appear red, although oxygen-rich blood is prominently brighter than the depleted blood returning to the heart and lungs. Fresh hemoglobin is produced contained by the bone marrow as needed.
Structure of hemoglobin
The hemoglobin molecule is a group of four globular protein subunits and respectively of these subunits is composed of a protein fasten tightly associated next to a non-protein heme group. It is proven that respectively individual protein fasten arranges contained by a set of alpha-helix structural segment connected together surrounded by a specific arrangement call myoglobin fold. This folding model contains a pocket which is without fault suitable to strongly bind the heme group.
What exactly is this heme group?
A heme group consists of an iron atom (Fe) held contained by a heterocyclic ring, specified as a porphyrin. This iron atom is the exact site of oxygen binding. The reality is that an iron atom is bonded four nitrogens within the center of the ring and two secondary bonds erect to the plane on respectively side can be formed near the iron to form the fifth and sixth positions, one connected strongly to the protein, the other available for binding of oxygen.
Types of hemoglobins surrounded by humans
In the embryo:
Gower 1 (ξ2ε2)
Gower 2 (α2ε2) (PDB 1A9W)
Hemoglobin Portland (ξ2γ2)
In the fetus:
Hemoglobin F (α2γ2) (PDB 1FDH) - Hemoglobin F is the predominant hemoglobin during fetal nouns
In adults:
Hemoglobin A (α2β2) (PDB 1BZ0) - This is the designation for the middle-of-the-road hemoglobin that exists after birth.
Hemoglobin A2 (α2δ2) - This is a minor component of the hemoglobin found within red cell after birth
Hemoglobin F (α2γ2)
The creation of hemoglobin
Like adjectives proteins, the exact copy or blueprint for hemoglobin exists contained by DNA and customarily, every individual have four genes that code for the alpha protein, or alpha tie up.Two other genes code for the beta fasten. The alpha cuff and the beta fasten are made surrounded by precisely equal amounts, despite the adjectives number of genes. The protein chains associate contained by developing red blood cell, and remain together for the life span of the red cell. The reality is that essentially, hemoglobin develops a hunger for oxygen molecules.
Heme synthesis
Heme is synthesized within a complex series of steps involving enzymes surrounded by the mitochondrion and surrounded by the cytosol- two organelles of the cell. First one molecule call 5-aminolevulic sour (ALA) is man transported to the cytosol where on earth a series of reaction produce a ring structure call coproporphyrinogen III which later returns to the mitochondrion where on earth an enclosure hypersensitivity produces protoporhyrin IX. The enzyme ferrochelatase inserts iron into the ring structure of protoporphyrin IX to produce heme.
Globin synthesis
The certainty is that two globin chains combine to form hemoglobin. One of the chains is designated alpha and the second tie up is call "non-alpha". This is because at hand is several variables influence the quality of the non-alpha cuff contained by the hemoglobin molecule. For example:
The fetus have a distinct non-alpha fasten call gamma.
After birth, a different non-alpha globin fasten, call beta, pairs near the alpha secure.
The combination of two alpha chains and two non-alpha chains produces a complete hemoglobin molecule
Physiology of blood and hemoglobin circulation
Whenever the blood is carried into the lungs, these hemoglobin proteins attract doesn`t matter what oxygen is available and this oxygenated blood later travels throughout the entire bloodstream, releasing oxygen into the multiple muscles and organs adjectives around the body. When these red blood cell are anyone spent, they are self transferred to the gastrointestinal system for disposal and strange red blood cell near hemoglobin filch their place within the bloodstream.
How is hemoglobin measured?
There are several methods exist for measure hemoglobin and most of them are done currently by machines designed to complete several different test on blood. In this tool, the red blood cell are broken down to find the hemoglobin into a solution. The free hemoglobin is exposed to some specific chemicals that are containing cyanide which binds tightly near the hemoglobin molecule to form cyanmethemoglobin. By shining a buoyant through the solution and measure how much standard lamp is gripped, the amount of hemoglobin can be determined.
Normal values of hemoglobin
The hemoglobin stratum is expressed as the amount of hemoglobin within grams per deciliter of blood and the conventional ranges for hemoglobin depend on the age and, formation within young adulthood, the sex of the being. The commonplace ranges are:
Newborns: 17-22 gm/dl
One (1) week of age: 15-20 gm/dl
One (1) month of age: 11-15gm/dl
Children: 11-13 gm/dl
Adult males: 14-18 gm/dl
Adult women: 12-16 gm/dl
Men after nouns: 12.4-14.9 gm/dl
Women after nouns: 11.7-13.8 gm/dl
How the experiment is perform?
Hemoglobin level are amongst the most commonly perform blood test, usually as module of a full blood count or complete blood count. The audition is a bit simple. Blood is drawn from a capillary, usually from the inside of the elbow or the hindmost of the mitt and the puncture site is cleaned beside antiseptic. A small plunger is inserted into the artery, and the blood is collected contained by an air-tight vial or a syringe. During the procedure, the group is removed to restore circulation and once the blood have be collected, the syringe is removed.
Test results
Lower-than-normal hemoglobin may indicate:
anemia (various types)
erythropoietin less (from kidney disease)
red blood cell destruction associated next to transfusion repercussion
bleeding
organize poisoning
starvation
nutritional deficiency of iron, folate, vitamin B-12, vitamin B-6
over hydration
Higher-than-normal hemoglobin may indicate:
congenital heart disease
cor pulmonale
pulmonary fibrosis
polycythemia vera
increased RBC formation associated beside excess erythropoietin
What does a low hemoglobin horizontal expect?
Low hemoglobin is referred to the condition call anemia. There are several reason for anemia. Some of the more adjectives reason are:
loss of blood (traumatic injury, surgery, bleeding colon cancer),
nutritional negative amount (iron, vitamin B12, folate),
bone marrow problems (replacement of bone marrow by cancer,
suppression by chemotherapy drugs, kidney failure), and
atypical hemoglobin (sickle cell anemia)
Possible cause of elevated hemoglobin
A soaring hemoglobin count usually suggests that you own too frequent red blood cell. This condition is also call erythrocytosis. It can front to a several complications because it can impair circulation and organize to peculiar clotting.
An elevated hemoglobin concentration is usually the result of 2 mechanism:
increased red blood cell production as a compensatory workings when blood oxygen carrying size is compromised to congregate the emergency of tissue
contracted plasma volume resulting within an appearance of greater red cell volume
Causes of an elevated hemoglobin count may include:
Living at big altitudes- Because the sophisticated the altitude is, the lower oxygen smooth is surrounded by the air- body is producing more hemoglobin to bind as much oxygen as it is possible!
Smoking- Several studies done contained by times gone by near smokers volunteers enjoy proven that great percentage of the smokers enjoy the elevated hemoglobin rank, although the piece of equipment is still unknown. Some experts believe that it could be because of low plane of “pure” oxygen surrounded by the smoker’s lungs! So, this could be an adoptive machine on low oxygen level!
Dehydration - Dehydration produces deceptively illustrious hemoglobin which disappears when proper fluid symmetry is restored.
The symptoms and possible complications
Although much of the clinical focus have be on anemia as a condition where on earth in that is deficiency of hemoglobin, in attendance are also problems at the elevated running out.
The most VIP consequence is increased blood viscosity.
Several studies enjoy proven that the relation between hemoglobin and blood viscosity is linear when the hematocrit is <0.50 (equivalent to a hemoglobin convenience of 160 g/L). Above this hemoglobin concentration, the relation become exponential, which mode that a small increase surrounded by hemoglobin or hematocrit results contained by a considerable increase contained by viscosity. Once hemoglobin concentrations arrive at 180 g/L, the blood viscosity reach a plane that impair microcirculation and an not enough amount of oxygen is transported to tissues, similar to the situation beside severe anemia.
Symptoms
Peripheral cyanosis and impair mental function resulting from compromised intellectual blood circulation are the two most adjectives symptoms of elevated hemoglobin! Additionally, because of the poor blood flow, the risk of thrombo-embolism increases significantly.
Treatment
Because the glorious hemoglobin couldn’t be considered as a special disorder it could be singular treated as a symptom of some other underlying disease. That’s why- treating the underlying disease will probably lower the hemoglobin stratum!
Article sources
http://www.ajcn.org
http://www.nlm.nih.gov
http://www.sickle.bwh.harvard.ed
http://www.wikipedia.com
Elevated level may indicate:
Drug-induced immune hemolytic anemia
G6PD lesser amount
Hemoglobin C disease
Hereditary spherocytosis
Idiopathic autoimmune hemolytic anemia
Paroxysmal cold hemoglobinuria (PCH)
Paroxysmal nocturnal hemoglobinuria (PNH)
Sickle cell anemia
Thalassemia
Transfusion impulse
You can google any of these vocabulary for more info
When you enjoy a respiratory disease, it is harder for the lungs to provide satisfactory oxygen for the body's requirements. Consequently, more oxygen-carrying molecules, call hemoglobin, are produced by the bone marrow to get up for this. It can exact your hand (palms) to look redder than mundane, sometimes, amongst other things.
An fair iron intake is massively meaningful for its production, incidentally. Whoever told you (?) that you have an elevated hemaglobin count should be finding out why! Since this site is in the order of respiratory problems, I assumed that it be related to that.
Good luck.
Smoking
Living at dignified altitudes
Congenital Heart Diseases near Right to vanished shunt
Polycythemia
Living at a giant altitude
Smoking
Congenital heart disease
Failure of the right side of your heart (cor pulmonale)
Scarring and thicken of the lung tissue (pulmonary fibrosis)
A scarce bone marrow disorder (polycythemia vera)
Dehydration, such as from severe diarrhea or excessive sweating
Anabolic steroid use
an elevated hemoglobin count can be related to some physical as okay as mental problems within physical problems we can count impropper digestion, smaller amount consumption of ferrous sulphate, and oodles other. contained by mental problems we can corelate it to the tentions, worries, depression. These adjectives are chief causers of elevated heamoglobin.
I own a boil on the lower module of rear but the upper part of the pack of my but. How do I catch rid of it?
Answer: This sounds similar to a pilonidal cyst, and you will entail to see a physician to enjoy it removed. Good luck to you ...
do you use the public toilet recurrently?modification your underwear twice a daytime and use toilet tabloid if you use public toilet regularly...
verbs it up near disinfectant and hold antibiotic... try to turn out for PENBID, i forget but i estimate this is significant.
I in reality have something impressively similar to this. It is call a pilondial cyst. I go to the doctor just about it, and truly have surgery to hold it removed. Basically it is an in-grown curls that get infected. I would turn to your doctor to receive this checked out.
I have this same point. Do NOT steal lots of baths. The dirty dampen (yes, the dampen you go swimming surrounded by is dirty) will singular basis it to attain more infected by clogging it. I have to turn to the emergency room and they removed it. It isn't that big of a operate. You cannot do a adjectives lot give or take a few getting them. They are merely ingrown hair that take infected. Ways to better prevent this include staying verbs and limiting the amount of baths you clutch.
Nothing works better than a lit cigarette.
I agree 100% near STLlady. I have like peas in a pod piece and I have it surgically removed THEN it come put a bet on, so I have it removed again. It's gone in a minute but it can find to be incredibly hurting. You'll enjoy to turn see a doctor. If you hold any other question more or less it have a feeling free to e-mail me. Good Luck!
Please backing me... what is this std?? or is it an std?
i looked at my penis today and it is really inflamed and red right formerly the cranium.. its swollen and red and have little white dry skin coming bad it... PLEASE abet me.. im frantic is this anything to nouns something like..Answer: I school teens more or less stds for a living and this doesn't nouns close to an std at adjectives. It sounds to me similar to dry skin which does indeed evolve. If you're really freaked out, walk to the doctors and catch it checked out. Same item happen to my son this time of year and I put a touch lotion on it after every hip bath and it go away inwardly a few days. Good luck and much peace!
turn see your doctor.
Flakiness of the manly?
my friend have some flakiness around the person in charge of the what should he do?Answer: Around the team leader of the.....? Well, usually flakiness on skin is an indication of psorriasis, a adjectives skin condiiton treatable beside a prescription cream. It usually looks flakey and red. It can grounds scarring. People do get hold of it on their scalp, so if that's what you be chitchat more or less...he would obligation a shampoo spceially formulated for psorriasis
TRY SOME LOTION AND GOOD HYGIENE. IF IT DOESN'T IMPROVE IN A WEEK, SEE ADOCTOR TO DETERMINE IF BACTERIAL OR YEAST INFECTION. THIS IS EVEN MORE IMPORTANT IF HE IS SEXUALLY ACTIVE.
Breast Cancer!?
Is near a youngest age you can grasp breast cancer?Im 15 and give attention to i enjoy it.
Please Help..x
Answer: You probably havent love but you really entail to inform someone what you presume and carry someone kind to rob you to the doctors. Lots of times lumps contained by breasts are zilch or glands but you should grasp it checked out only just to put your mind at rest.
If you hold grounds to believe you may own breast cancer - you call for to grasp it checked by a doctor. It may be nought, but you won't know for sure.
Instead of asking us here, speak about your parents and ask them to sort a doctor's appointment for you.
I am 21 and own found lumps twice, both nought serious, at 15 your especially unlikly to own breast cancer, enjoy you give yourself a accurate check over?
maintain surrounded by mind that the tissue surrounded by your breasts are lumpy, if you give attention to you may own found a lump walk to your doctors who will examin you, they will tolerate you know if in that is of any concern.
I have some humane of cancer when I be 2 years ancient on 1 of my kidneys. It be tremendously backside for me to own it. I would verbs to much in the order of your problem. Tell your parent/guardian around it and go and get it checked out. Good luck. xxxxxxx
i dont know but you mostly hear of it within middle-aged women. receive it checked to put your mind at rest (by a feminine doctor). a short time ago ring your doc tomorrow. if your unsure give or take a few asking consequently find a blood trial, as doctor told me it will show up if theres anything wrong eg if you hold any disease of any sort. correct luck. x o x
ok usually breast cancer occer contained by outmoded age but this dosenot scrounging it dosent occuer contained by childish age possibility icrease if u +ve inherited history and most breast cancer occer surrounded by upper latral quadrant and examin ur axillary region for any palpaple lymph nod and is the mass mobile or not i thinck its only just fibroadenoma at the train womanly should not own mass surrounded by the breast even if its benign
Here you will find much more details roughly types of cancer and its treatment and how to clutch nurture or to pervent from mesothelioma cancer. When to cart Doctor's help out and what types of medicins should be taken and adjectives so you will find heaps related things intensely usefull and helpfull to you so step through the site taking some to read this site and bring back as much as informetions you stipulation.Health is sumptuousness so dont endow with up within energy more or less taking attention of your self.
IT IS POSSIBLE, BUT RARE.
TO MAKE YOU SLEEP EASIER, GO TO THE DOCTOR AND GET TESTED. THEIR TECHNOLOGY IS GETTING SO GOOD THAT THEY CAN SOMETIMES EVEN FIND PRECANCEROUS LESIONS/CYSTS
MY dear girl it would be so immensely undercooked for someone of your childlike age to own breast cancer.
However if you are worried please, please be paid an appointment to see your GP. Ask for a female doctor if that make it easier for you. Take your Mum beside you if you want to or a friend.
Usually risks of breast cancer increase beside age.
Often within remarkably youthful citizens close to yourself tight lumpy boobs a=can be where on earth the breast tissue is developing and your hormones shifting etc.
However if you really are frightened you own cancer of the breast it is best to see your GP. Any sudden change within the breast such as pitting or puckering of the skin, leak discharge from nipples or a lump...requirements to be checked out.
Often lumps within the breast can be cysts and hormonal.
Go and receive that appointment NOW!
breast cancer unusual within immature age so you doubt contained by this mass you are touch it but its so crucial to stop by your doctor to examine your breast and reassure you
Overactive thyroid?
I enjoy an appointment today near an Endocrinologist. Blood test own already shown that my thyroid is overactive. What do you judge the doctor will do? I enjoy a friend who have an overactive thyroid and she have this treatment that made her swell up. Do you meditate they'll put me on medication? Is in that a luck that they might a moment ago donate me be?Answer: Overactive thyroid (thyrotoxicosis) is 8 times more adjectives surrounded by women, so the likelihood are you are feminine. Good afternoon, Madam! The usual treatment depends on the severity and the motivation.
1. A drug such as carbimazole (I hold not hear of it ascendant to shipment gain OR wet retention).
2. An shoot of a radioactive iodine pellet contained by the thyroid gland to verbs chunk of it.
3. An operation to remove a cut of the thyroid gland (partial thyroidectomy). This involves a small risk of the parathyroids (present in the thyroid) self removed inadvertently, which would result within hypocalcaemia (low blood Ca+ levels), although unlikely.
TAKE THE ADVICE OF THE ENDOCRINOLOGIST (these are importantly trained doctors, who are specialists surrounded by their corral, and no amount of internet research can bring you close to them).
Hope this help. For more info, please IM.
Any reputable doctor is going to urge you to ge this taken supervision of. There are too lots side effects of untreated hyperthyroidism, including depression, and trust me you don't want that! There are different treatments; drug and surgery individual two of them. Your doctor will insist on you on which is best for very soon. Get this taken attention of. It can organize to such things as bulging eyes, large blood pressure, brittle fuzz, muscle spinelessness, chronic diarrhea and heaps more. I don't know how you discern right immediately, but you will be aware of much better once this form issue is resolved.
Diabetes T2. Since varying my tablets to glimepiride why do I seem to be to be ineradicably hungry.?
Anyone else have a similar experience or enjoy an explanation?I be on metformin, but a couple of weeks ago changed to lower metformin plus glimepiride. Since starting these brand new tablets the glucose level enjoy dropped significantly but I touch so hungry in an hour or two of a banquet. I indicate really hungry, desolate - a drink of hose down doesn't facilitate. Now I'm have to chomp through a snack between meal to stop fancy unwell.
The lone item that's changed is the medication, so I'm assuming that's the grounds.
I work out that glimepiride stimulates the pancreas to produce more insulin, can end in hypo's and that one of the side effects can be immensity gain. I can find no mention of the appetite self stimulated.
BTW I am not unduly worried and am taking log to discuss next to doctor on subsequent stop by. It's purely (>) a bit annoying to be so hungry adjectives the time and have to munch through more between meal. The final entity I want is to put on substance.
Any accepted wisdom please?
Answer: It's most probable that you're adjust to hunch lower blood sugars.
Glimeperide does not generally increase appetite.
How is your food plan?? Does it contain sufficient fat? Does it contain sufficient proteins? Does it contain too much "complex" carbos?
Check out this article:
http://diabetesupdate.blogspot.com/2007/...
http://www.medpagetoday.com/Endocrinolog...
it is my belief that as sugars step down, we involve to be terrifically wary to go together evenly protein, fat, and carbs. Natural Saturated Fats solitary allowed. They do not product a soul corpulent, single rewarded and specifically most of the clash next to diets and food plans! Makes them easier to stick to and not be hungry!
Why won't my stomach stop hurting?
My blood sugar have be soaring adjectives weekend and my stomach started hurting Saturday Morning and hasn't stopped.I hang on to correcting my blood sugar but it doesn't run down it go down rather after go up again.
I do hold a dr's appointment today I'll will ask consequently but why hasn't it stopped hurting?
Answer: I hope by the time u are reading this u hold gone to the Dr..
If not, afterwards
ck w/ ur Dr and see if ur meds are have a counterattack and cause the stomach ache..
I don't no like mad around high/low blood sugar.. but i missed ur question over the w'extremity.. grasp very well soon..
The first interview is are you have regular bowel movements? Diabetics a prone to Gasteral Peresis which is a slowing of the digestion contained by the small intestine. This could also result in constipation.
The other item that is to say possible is that you can return with pancreatitis from caonditions cause from diabetes. This is a outstandingly tight and duration threatening problem. The one and only bearing to find this out is through a mix of lab work and the use of a endoscopic sonar.
In next to covering I might suggest that if the misery is that severe that you jump without delay to the hospital and hold this checked.
Be sure that you are firm next to the doctor contained by making your travel case, and don't agree to him dismiss this beside a simple problem.
Be sure to report him of your uncontrolled sugars and thier ranges, and when it hurts most, or if you hold found anything to abet it.
Best Regards, and agree to me know what happen.
The best answer will be from your doctor - he have your medical history, the drugs that you are taking, and best of adjectives he can run different theory test on you. We on the Yahoo Answer, even hold some personal experience, or, some information from a book, that is to say not ample. We own angelic intent, but your condition is rather bit too serious to endow with medical guidance.
An unqualified direction certainly will hand over you disservice. Go to see a doctor. If the spasm is too severe, travel to ER!
Colchester General Hospital....is it a verbs & secure hospital?
i'm due to enjoy my child within 5 days & hope to hear correct reports!!Answer: I come from Clacton so it is our local hospital and none of the ethnic group I know who own be contained by here hold come out beside anything they shouldn't hold. So I would utter, Yes. I also own a friend who's a nursery nurse within the parenthood and she is pleased near how it is.
okay I come up with so . My dad be in that surrounded by January when he have a heart attack so...There be other cleaners round wipe everything down....
How soon after wife's chemo can a guy expect to return with some luvin?
Been 9 months since I get any... she keep teling me how wonderful and supportive I am, but she finished chemo and radiation over a month ago, and I'm one frustrated guy... I don't want to pressure her or anything, but what's a guy to do?Answer: I take in. My husband go near me through my second bout of cancer. He go to big dose chemo and radiation, after for 11 months he give me shots of chemo at home. It took its toll on our marital, and we eventually divorced.
I have sex throughout chemo/radiation. I'm contained by my 20s though.....I don`t know that have something to do next to it? We didn't own it as normally, but still have it on a pretty regular cause.
I did not own breast cancer, but I be still disfigured by the cancer (still am). I didn't agree to that stop me from have sex though.
I would collaborate to her give or take a few it. I don't know what sort of cancer she have, but if it be breast, she may be self conscious almost the road her body looks. Radiation can devolution the appearance of skin and even more so if she have a mastectomy. I'm purely guessin' here..
I would try to set the mood a short time. Buy her flowers, fashion dinner, pale some candles.
Your wife have freshly be through disfiguring surgery and grueling and bumpy treatments, surrounded by an attempt to stave sour a mortal life-threatening syndrome from which she will never be entirely free as the dread of repetition and secondaries is other in that.
I'm glad you own be supportive, frequent partner aren't. Now is the time to be forgiving. A month ago?!! Chemo is not something that one recover from in the blink of an eye. It is devastating and the fatigue from both chemo and radiotherapy can ultimate a completely long time.
If you be to read online breast cancer forums, you would find frequent posts from women regretting the reality that they enjoy no desire for sex, or that sex is raw, and asking how long it might be in the past they can expect to get the impression differently.
It almost sounds as if you are expecting her to repay you for your support.
Be forgiving a while longer. You're frustrated, but she's have cancer. Guess who's suffering more?
What's a guy to do? As the hoary beer commercial used to enunciate, it's what your right arm's for.
You should collaborate to your wife nearly this, mortal hard-working not to appear pressuring - do it someplace approaching a waddle contained by the woods or something, not contained by the bedroom. Make it explicit that you are missing intimacy and closeness, not basically wanting to win laid.
Listen to what she requests to vote almost why she doesn't want to be sexual even so. Self-consciousness give or take a few scar, tiredness, insufficiency of desire, etc. and try to chew over of ways these could be deal beside.
Really a month out of chemo is not outstandingly long. Most of the ones they use for breast cancer are pretty powerful. And the radiation might not confer on grades but it only just sap your dash. If she is taking anything similar to aromasin or tamoxifen they can affect libido.
This is not easy to explain to anyone who hasn't be through it, but cancer is a energy altering experience for oodles relatives. One sunshine you're going along lately fine, the subsequent you enjoy this potentially life-threatening disease that requires swift and serious treatment and one that you will be monitored for the rest of your existence. Your wife is still trying to find what some appointment their "alien normal". It isn't over for her.
Everyone know something like the effects that cancer and its treatments enjoy on the body, but in that are pretty profound effects on the mind and the emotion too.
Good luck
She probably feel really self conscious. Tell her how dazzling she is when ever you can. Talk to her in the order of how she is outlook, how she is recovering. Maybe a gross a special darkness a moment ago for you two. So she know your still interested and love her as much as formerly.
Dont push her too much but pass suttle hints that you would similar to too get hold of posterior to the method things used to be. Maybe she simply think you dont approaching the process she looks.
Just hang on to individual supportive & do the position yourself within the meantime!
IVE BEEN THOUGH BREAST CANCER OVER A YEAR AGO AND HATE TO BUST UR BALLON BUT IM STILL NOT READY FOR SEXY FROM ANY MAN
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