NF1 Next Step


NFormation is looking to do something about the well-known difficulties that adult NF1 persons have in finding and engaging a physician “sufficiently knowledgeable” about NF1 so as to optimize the NF1 person’s, the NF1 client’s health. As both a specialist pediatrician and a board certified specialist in internal medicine, I have long been aware of this deficiency: individuals I’d engaged as a “Recklinologist” in the 1970s, 1980s and the 1990s as children or teenagers frequently recontact me now, hoping that I can direct them to clinicians “sufficiently knowledgeable” about NF1 to address all of their health care needs. Regrettably, I’ve rarely been able to do so – because such doctors are so few, and/or they have no way for broadcasting their sought-after talents.


A Recklinologist is a doctoral-level clinician or researcher who devotes himself or herself to understanding NF1 and/or to directly helping NF1 persons have the most ordinary and successful life possible. There may be about 75 such persons – Recklinologists – in the USA presently. In general, they are readily identified and accessible, and many, if not most of them, are pediatricians in one sense or another. But the vast majority of NF1 persons are adults, with a significant portion in the age range of geriatrics. Obviously, such persons with NF1 need access to doctors both versed in adult medicine and enthusiastic about NF1. In this latter regard, I will make frequent reference to “NF1-enthusiastic” physicians, whether a Primary Care Physician (PCP) or Specialty Care Physician (SCP).


NFormation will seek out both PCPs and SCPs, with an emphasis on the latter initially. Exactly how we do this and how we enable the NF1 clients’ access to these NF1-enthusiastic practitioners still has to be worked out or formulated. In the meantime, the NF1 adult should know – even celebrate – that I am committed to this project, to these goals.


As a start, I am going to key off a very successful program that was central to an earlier enterprise for which I was responsible, namely, American Medical Consumers (AMC). That successful AMC program was dubbed “Next Step.” We literally helped clients determine and act upon realistic choices as they navigated the health care delivery system, i.e., took the Next Step. (This information should clarify why the URL for the NFormation website is designated as Ultimately, I and NFormation will help the NF1 client determine and take the best Next Step towards his or her NF1-considered health care goals.


A key consideration here is the distinction between “Medical Decision Making” (MDM) and “Executive Decision Making” (EDM). We have helped, and will essentially continue to help NF1 clients with their EDM. This consideration is also addressed in the NFormation Update entitled “NF1 persons vs. NF1 Patients,” an important element of NFormation’s inauguration.[LINK]


Executive Decision-Making

Consider a person, Leona, who is told by her doctor that one week hence, next Thursday, she needs to have an early-morning fasting blood sugar (FBS) determination. He then goes on to specify how she should prepare for it, specifically, nothing to eat or drink after midnight. The following Tuesday afternoon, as she plans how to use her time on Thursday, the blood-drawing day, she calls NFormation for assistance. First, it is established that she is engaging NFormation as a CLIENT. Second, it is clarified that she lives on Briggs Avenue in La Crescenta, CA. She is then advised that she can drive the 10 miles or so to Pasadena and use the laboratory facility in the building where she ordinarily engages her doctor or use the commercial laboratory facility in Montrose, just a little over two miles from her home. She is also advised that the commercial laboratory is part of her physician’s network and, further, that it is included in her healthplan resources. Given these facts, particularly the closeness of the commercial laboratory and her planning to meet her sister, Etiwanda, that Thursday for breakfast in Montrose after the blood draw, she opts to have her blood drawn at the nearby commercial laboratory. This executive decision makes good sense from virtually every vantage point – and in no way compromises the medical decision-making that determines the need to draw blood.


Does it make any difference as to who was the person from NFormation that assisted her; and what was that person’s background and training? Was it a janitor, a secretary, a phlebotomist, a nurse, a medical student or a physician? What if it was a physician? Respecting that any one of these persons could have appropriately provided the information to afford Leona’s EDM, it would seem that the physician providing the information could and should not be construed as thereby practicing medicine.


My concern here is to have consensus that physicians can supply information affording EDM – as opposed to MDM – without practicing medicine. From there, we can graduate to a whole series of decision-making scenarios to which a physician can contribute without ipso facto practicing medicine. And this would apply to all physicians, with or without a current, active medical license.


Very specifically, I, Vincent M. Riccardi, MD, can and will provide information and certain types of advice relevant to NF1 even without a current, active California medical license. I will do so both in face-to-face engagements and in writing, including text that is the substance of NFormation.


I have done this previously, for some three years or so, as an agent of the organization, American Medical Consumers (AMC), most often as part of AMC’s Next Step program. In that program, a participating business paid AMC a fixed fee per employee per month for each employee’s privilege of consulting with me about taking the next step in an anticipated or ongoing clinical situation. (This privilege was afforded each employee and his or her spouse and all first-degree relatives.) The most common client inquiries involved knee or hip joint replacements for a parent (or sometimes a mother-law or father-in-law).


The issue was never whether to have the surgery. Rather, the issue was providing information about various decisions to be made along the way, for example, about the various types of prostheses and the facility where the surgery would or could be performed. I strictly provided only information to be used for EDM after the surgical candidate made the final plans in concert with his or her physicians, including the surgeon. The issue was never whether the treatment, surgical or otherwise, was appropriate, but rather about details along the way. The issue never was whether or not to take the next step, but, rather, maximizing the client’s input in the EDM along the way.


In these AMC engagements I was very explicit about the fact that I was not practicing medicine in providing Next Step assistance. I would explicitly declare that “I am not practicing medicine, but rather helping you make a series of executive decisions in the next step you (or your relative) are considering.” Moreover, I always asked the client if he or she understood the distinction I was making. The clients uniformly responded that they understood. They knew, as well, that they were clients (a type of customer). More pointedly, they were not patients when part of the Next Step transactions.


This same approach is legitimate and necessary for so many of the Next Steps to be made in the health care of NF1 persons.


I am a storehouse of information relevant to NF1 EDM: my Curriculum Vitae is available elsewhere in NFormation.[LINK] It seems inappropriate that none of that information could be available to NF1 clients merely because I elected not to renew my licensure. (That is, the decision not to renew was mine alone. Specifically, it was not a sanction by the licensing agency.) NFormation, medical and scientific journal publications, participation in NF advocacy group meetings and visiting with an NF1 person or family privately are among the many ways I can and will share my NF1 information to facilitate NF1 Next Step EDM. The fact that I was one of the founders of the Texas NF Foundation (TNFF) in the early 1980s and that I am currently the Medical Director of NF California (NF CA) attest to my ability and enthusiasm for contributing to NF1 health care above and beyond MDM.


Can I opine in a clinical setting if I don’t have a medical license? Can I give advice in a clinical setting if I don’t have a medical license? Yes, I can, specifically as an EDM-Facilitator.


As an EDM-Facilitator, I will not propose or make a diagnosis. I will not propose or suggest a treatment. I will otherwise help the CLIENT navigate the health care delivery system by facilitating EDM, respecting a purported or established diagnosis. In the capacity of EDM-Facilitator, I will, for example, assist the client in itemizing facilities/institutions that provide the anticipated treatment. More generally, I will assist the client in itemizing various types of questions he or she might want to ask the physician(s) regarding various details about the proposed diagnosis and/or proposed treatment. For example, given a new/recent diagnosis of NF1, will “whole body MRI” be utilized? If the client is being managed by an NF1 specialist physician (“Recklinologist”), the EDM-Facilitator’s input may be superfluous. On the other hand, if the managing physician has little or no experience with NF1, the input may be useful to both the client and the physician. The management of NF1 is often complex and the client can and should be part of the associated EDM that is part of that complexity.


What I have just described is a major part of NFormation’s NF1 Next Step program, intended to help NF1 clients make truly informed executive decisions.


NF1 Next Step: Lighting the way to better health care choices.



  1. Pingback: viagra price walmart

  2. Pingback: cialis 10mg

  3. Pingback: cheap cialis

  4. Pingback: how to get cialis

  5. Pingback: viagra 50mg

  6. Pingback: buy ed pills online

  7. Pingback: top erection pills

  8. Pingback: cheapest ed pills

  9. Pingback: generic cialis online

  10. Pingback: pharmacy online

  11. Pingback: rx pharmacy

  12. Pingback: Real cialis online

  13. Pingback: vardenafil canada

  14. Pingback: levitra vardenafil

  15. Pingback: levitra online

  16. Pingback: betfair casino online

  17. Pingback: sugarhouse casino online

  18. Pingback: cheap viagra online canadian pharmacy

  19. Pingback: casino games online

  20. Pingback: pala casino online

  21. Pingback: generic cialis tadalafil

  22. Pingback: cash loans

  23. Pingback: loans for bad credit

  24. Pingback: cash loan

  25. Pingback: viagra for sale

  26. Pingback: caesars casino online

  27. Pingback: best real money online casinos

  28. Pingback: cialis internet

  29. Pingback: play keno online victoria

  30. Pingback: casinos online

  31. Pingback: gamblingoninternet

  32. Pingback: new cialis

  33. Pingback: 20 cialis

  34. Pingback: cialis internet

  35. Pingback: 20 cialis

  36. Pingback: casino slot games

  37. Pingback: best online casino

  38. Pingback: casino slots

  39. Pingback: best online casino

  40. Pingback: viagra online canada

  41. Pingback: viagra buy

  42. Pingback: order viagra

  43. Pingback: buy cialis

  44. Pingback: tadalafil 20

  45. Pingback: casino slots

  46. Pingback: casino slot

  47. Pingback: viagra without a doctor prescription

  48. Pingback: cheap cialis tablet

  49. Pingback: Viagra 100mg united states

  50. Pingback: Viagra 50 mg canada

  51. Pingback: Viagra 50mg no prescription

  52. Pingback: Viagra 130 mg australia

  53. Pingback: hydroxychloroquine for sale

  54. Pingback: buy cialis online us pharmacy

  55. Pingback:

  56. Pingback:

  57. Pingback: cialis for sale

  58. Pingback: Cialis 10 mg united states

  59. Pingback: sildenafil

  60. Pingback: viagra canada

  61. Pingback: Cialis 20 mg online pharmacy

  62. Pingback: cheap cialis

  63. Pingback: Cialis 40mg otc

  64. Pingback: buy Cialis 60mg

  65. Pingback:

  66. Pingback: levitra 40mg without a prescription

  67. Pingback: lasix 100mg without a doctor prescription

  68. Pingback:

  69. Pingback: furosemide 40 mg without a prescription

  70. Pingback: propecia 5 mg online

  71. Pingback: viagra generic

  72. Pingback: otc viagra

  73. Pingback: lexapro 5 mg without a doctor prescription

  74. Pingback: finasteride 5 mg medication

  75. Pingback: where to buy viagra

  76. Pingback: abilify 10 mg online

  77. Pingback: actos 30 mg prices

  78. Pingback: allegra 180mg over the counter

  79. Pingback: how to buy allopurinol 300mg

  80. Pingback: get viagra without doctor

  81. Pingback: amaryl 4 mg no prescription

  82. Pingback: ampicillin 250mg coupon

  83. Pingback: arava 10mg pills

  84. Pingback: pfizer viagra tablets

  85. Pingback: beerich cialis

  86. Pingback:

  87. Pingback: arimidex 1 mg coupon

  88. Pingback: cialis kidney disease

  89. Pingback: avapro 150 mg otc

  90. Pingback: buy viagra in ireland

  91. Pingback: avodart 0,5 mg tablet

  92. Pingback: baclofen 25 mg price

  93. Pingback: bactrim 400/80mg cheap

  94. Pingback: is generic cialis real

  95. Pingback: benicar 40 mg without a doctor prescription

  96. Pingback: Premarin 0,3mg united kingdom

  97. Pingback: buspar 5mg for sale

  98. Pingback: cialis price uk

  99. Pingback:

  100. Pingback: calcium carbonate 500mg prices

  101. Pingback: cost of cardizem 60 mg

  102. Pingback: how to buy viagra in ireland

  103. Pingback: casodex cheap

  104. Pingback: ceclor tablet

  105. Pingback: ceftin 500mg tablets

  106. Pingback: celebrex 200mg cheap

  107. Pingback: celexa cost

  108. Pingback: cephalexin price

  109. Pingback: cipro 500 mg otc

  110. Pingback: claritin generic

  111. Pingback: real casino games

  112. Pingback: free slots

  113. Pingback: slots online

  114. Pingback: real casino online

  115. Pingback: real online casino

  116. Pingback: online casinos usa

  117. Pingback: slot machine games

  118. Pingback: online casino usa real money

  119. Pingback: real casino online

  120. Pingback: gambling casino

  121. Pingback: car insurance quotes for young drivers

  122. Pingback: viagra 100 mg

  123. Pingback: cheap car insurance quotes in florida

  124. Pingback: ameriprise car insurance quotes costco

  125. Pingback: collector car insurance quotes

  126. Pingback: progressive insurance quote

  127. Pingback: best generic cialis

  128. Pingback: au cialis

  129. Pingback: car insurance usaa

  130. Pingback: foremost car insurance quotes

  131. Pingback: buy cialis

  132. Pingback: car insurance quotes ontario

  133. Pingback: cheap car insurance quotes online

  134. Pingback: personal loans hamilton ontario

  135. Pingback: payday loans california

  136. Pingback: cialis online

  137. Pingback: online payday loans

  138. Pingback: Canada meds viagra

  139. Pingback: online installment loans

  140. Pingback: bad credit quick loans

  141. Pingback: best place to buy viagra online forum

  142. Pingback: buy cialis canada

  143. Pingback: bad credit loan today

  144. Pingback: payday loans

  145. Pingback: personal loans online

  146. Pingback: cbd oil wholesale

  147. Pingback: can i buy cbd hemp oil at walgreens

  148. Pingback: cialis order

  149. Pingback: cannabis seeds high in cbd

  150. Pingback: viagra in usa

  151. Pingback: female viagra uk pharmacy

  152. Pingback: dosage of cbd oil for chronic pain

  153. Pingback: best female viagra pills in india

  154. Pingback: cbd hemp oil vape juice

  155. Pingback: reputable cbd oil companies

  156. Pingback: viagra super active plus

  157. Pingback: buy levitra safely online

  158. Pingback: cbd oil for sale in colorado springs

  159. Pingback: cbd oil for cancer for sale

  160. Pingback: compare sildenafil prices

  161. Pingback: generic viagra for daily use

  162. Pingback: viagra tablets in hyderabad

  163. Pingback: buy an essay paper

  164. Pingback: are essay writing services legal

  165. Pingback: good essay writing service

  166. Pingback: online homework help

  167. Pingback: freedom writer essay

  168. Pingback: cheap research paper writers

  169. Pingback: viagra medicine online

  170. Pingback: french homework

  171. Pingback: buying essay

  172. Pingback: college paper writers

  173. Pingback: federalist paper writers

  174. Pingback: cleocin 300mg for sale

  175. Pingback: clomid 25mg nz

  176. Pingback: price of viagra 50 mg in india

  177. Pingback: Sale viagra

  178. Pingback: order cialis overnight delivery

  179. Pingback: clonidine 0,1 mg pharmacy

  180. Pingback: clozaril 50mg cost

  181. Pingback: colchicine prices

  182. Pingback: buy cialis using paypal

  183. Pingback: Brand viagra

  184. Pingback: symbicort inhaler 160/4,5 mcg no prescription

  185. Pingback: combivent prices

  186. Pingback: buy viagra pfizer

  187. Pingback: coreg 25 mg without a prescription

  188. Pingback: help with college essay

  189. Pingback: cialis

  190. Pingback: cialis mail order pharmacy

  191. Pingback: compazine otc

  192. Pingback: generic viagra next day delivery

  193. Pingback: coumadin 1 mg uk

  194. Pingback: cozaar 25mg cheap

  195. Pingback:

  196. Pingback:

  197. Pingback:

  198. Pingback: crestor nz

  199. Pingback:

  200. Pingback: dissertation writing jobs

  201. Pingback: college essay help long island

  202. Pingback: cymbalta 60mg united kingdom

  203. Pingback: custom essay writing service toronto

  204. Pingback: order cialis without prescription

  205. Pingback: dapsone caps price

  206. Pingback: thesis abstracts

  207. Pingback: How to get viagra

  208. Pingback: ddavp pills

  209. Pingback: depakote online pharmacy

  210. Pingback: diamox united kingdom

  211. Pingback: cheapest differin

  212. Pingback: diltiazem 60 mg prices

  213. Pingback: doxycycline cheap

  214. Pingback: cheap dramamine 50 mg

  215. Pingback: how to purchase elavil

  216. Pingback: erythromycin 500mg cheap

  217. Pingback: etodolac over the counter

  218. Pingback: flomax without a prescription

  219. Pingback: flonase nasal spray 50 mcg coupon

  220. Pingback: essay help chat room

  221. Pingback: garcinia cambogia 100caps coupon

  222. Pingback: order cialis in australia

  223. Pingback: geodon 80mg usa

  224. Pingback: where can i buy hyzaar

  225. Pingback: imdur 20 mg online pharmacy

  226. Pingback: pharmacy

  227. Pingback: how long does it take for cialis to work

  228. Pingback: buy cialis online

  229. Pingback: imitrex cheap

  230. Pingback: cialis 20mg price

  231. Pingback: imodium 2mg australia

  232. Pingback: order generic cialis

  233. Pingback: look at this web-site

  234. Pingback: how long does viagra take to work

  235. Pingback: how does viagra work

  236. Pingback: imuran over the counter

  237. Pingback: viagra without prescription

  238. Pingback: indocin 25 mg nz

  239. Pingback: ordering cialis in canada

  240. Pingback: lamisil 250 mg without a doctor prescription

  241. Pingback: levaquin 250 mg canada

  242. Pingback: buy lopid

  243. Pingback: lopressor cost

  244. Pingback: where to buy luvox 50 mg

  245. Pingback: macrobid medication

  246. Pingback: viagra 150 milligrams

  247. Pingback: meclizine 25 mg medication

  248. Pingback: cheapest mestinon 60mg

  249. Pingback: pharmacy online

  250. Pingback: Cialis Super Active

  251. Pingback: micardis united states

  252. Pingback: india pharmacy

  253. Pingback: canada pharmacies/account

  254. Pingback: buy viagra online canada

  255. Pingback: motrin 600 mg pills

  256. Pingback: price prescription drugs

  257. Pingback: where can i buy nortriptyline 25mg

  258. Pingback: hydroxychloroquine medication

  259. Pingback: ventolin inhaler copay card

  260. Pingback: phenergan 25 mg tablet

  261. Pingback: cialis generic price walmart

  262. Pingback: prednisolone 5 mg without prescription

  263. Pingback: prevacid 15mg generic

  264. Pingback: prilosec otc

  265. Pingback: proair inhaler united states

  266. Pingback: traveling with medications tsa

  267. Pingback: procardia 30mg medication

  268. Pingback: proscar cheap

  269. Pingback: viagra quick tabs

  270. Pingback: how to purchase protonix

  271. Pingback: healthy man dapoxetine pills

  272. Pingback: provigil 200mg generic

  273. Pingback: pulmicort 100mcg united kingdom

  274. Pingback: pyridium pills

  275. Pingback: reglan generic

  276. Pingback: generic of viagra

  277. Pingback: how to purchase remeron

  278. Pingback: retin-a cream 0.025% usa

  279. Pingback: revatio 20mg tablets

  280. Pingback: cost of risperdal 1mg

  281. Pingback: robaxin 500mg online

  282. Pingback: rogaine 5% nz

  283. Pingback: cheapest seroquel

  284. Pingback: how to purchase singulair

  285. Pingback: skelaxin 400mg cost

  286. Pingback: buy viagra vidalista levitra online

  287. Pingback: spiriva 9 mcg pills

  288. Pingback: using viagra

  289. Pingback: natural cialis alternatives that work

  290. Pingback: tenormin 25 mg without prescription

  291. Pingback: getting cialis in tijuana

  292. Pingback: thorazine 100mg without prescription

  293. Pingback: toprol 50 mg cheap

  294. Pingback: generic viagra usda virginia

  295. Pingback: tricor 200 mg without a prescription

  296. Pingback: valtrex 500mg prices

  297. Pingback: vantin online

  298. Pingback: real viagra sex

  299. Pingback: verapamil 40 mg no prescription

  300. Pingback: voltaren 50 mg without prescription

  301. Pingback: wellbutrin 300mg uk

  302. Pingback: buy cialis canadian pharmacy

  303. Pingback: comparison viagra and cialis

  304. Pingback: liquid cialis blue bottle

  305. Pingback: zanaflex pharmacy

  306. Pingback: brand cefixime online canadian pharmacy cefixime brand

  307. Pingback: go to my site

  308. Pingback: cheapest zocor

  309. Pingback: zovirax 800 mg purchase

  310. Pingback: buy viagra from india

  311. Pingback: zyloprim online

  312. Pingback: zyprexa 15mg without a prescription

  313. Pingback: zyvox online

  314. Pingback: where to buy sildenafil

  315. Pingback: clomid or nolvadex

  316. Pingback: dangers of vidalista use

  317. Pingback: tadalafil 80mg over the counter

  318. Pingback: buy furosemide 40mg

  319. Pingback: escitalopram 10 mg usa

  320. Pingback: aripiprazole without a doctor prescription

  321. Pingback: buy female viagra

  322. Pingback: pioglitazone prices

  323. Pingback: vidalista 80mg black

  324. Pingback: cialis generic prices

  325. Pingback: spironolactone cost

  326. Pingback: fexofenadine purchase

  327. Pingback: viagra coupons printable

  328. Pingback: glimepiride 2 mg australia

  329. Pingback: cheap meclizine

  330. Pingback: where to buy leflunomide 20 mg

  331. Pingback: sildenafil active ingredient in viagra

  332. Pingback: atomoxetine over the counter

  333. Pingback: donepezil 10mg canada

  334. Pingback: anastrozole 1 mg cheap

  335. Pingback: irbesartan 150mg without a prescription

  336. Pingback: how to purchase dutasteride

  337. Pingback: olmesartan otc

  338. Pingback: cheapest buspirone

  339. Pingback: clonidine usa

  340. Pingback: cefuroxime 500 mg without a prescription

  341. Pingback: how to purchase celecoxib

  342. Pingback: genericcialis

  343. Pingback: order citalopram 10mg

  344. Pingback: cephalexin 500 mg uk

  345. Pingback: cialis for sale on amazon

  346. Pingback: loratadine without prescription

  347. Pingback: buy prescription medication online

  348. Pingback: which is more effective cialis or viagra

  349. Pingback: cialis payment with paypal

  350. Pingback: cheap clindamycin 300mg

  351. Pingback: what is the cost of generic viagra

  352. Pingback: how to get ciails without a doctor

  353. Pingback: where to buy clozapine 50mg

  354. Pingback: buy prochlorperazine

  355. Pingback: buy cialis canadian

  356. Pingback: cheapest carvedilol

  357. Pingback: cialis viagra gr

  358. Pingback: Cialis Professional

  359. Pingback: warfarin 5mg nz

  360. Pingback: rosuvastatin united states

  361. Pingback: desmopressin 10mcg pharmacy

  362. Pingback: divalproex canada

  363. Pingback: viagra en sydney

  364. Pingback: tolterodine 1 mg purchase

  365. Pingback: acetazolamide online

  366. Pingback: cialis 20 mg price

  367. Pingback: fluconazole 150mg over the counter

  368. Pingback: amoxicillin for cats dosage

  369. Pingback: phenytoin uk

  370. Pingback: oxybutynin 5 mg united kingdom

  371. Pingback: how to buy cialis online from canada

  372. Pingback: white pill 703 otc canadian

  373. Pingback: azithromycin for sinus infection

  374. Pingback: where to buy doxycycline

  375. Pingback: celebrex peak plasma

  376. Pingback: buy viagra online australia paypal

  377. Pingback: viagra pills wholesale

  378. Pingback: cost of bisacodyl

  379. Pingback: cephalexin pharmacology

  380. Pingback: monthly cost of cialis without insurance

  381. Pingback: venlafaxinemg united kingdom

  382. Pingback: duloxetine hcl 60mg

  383. Pingback: amitriptyline 50 mg australia

  384. Pingback: fish amoxicillin for humans

  385. Pingback: permethrin united states

  386. Pingback: buy cialis online cheap

  387. Pingback: 141genericExare

  388. Pingback: where to buy erythromycin 250mg

  389. Pingback: buy cialis tadalafil tablets

  390. Pingback: 141generic2Exare

  391. Pingback: zdpozdar

  392. Pingback: tadalafil overdose

  393. Pingback: estradiol 1mg online

  394. Pingback: cialis tadalafil portugal

  395. Pingback: etodolac 200 mg tablets

  396. Pingback: tamsulosin cheap

  397. Pingback: azithromycin tablet usp 250 mg

  398. Pingback: can you buy azithromycin

  399. Pingback: xxfaofte

  400. Pingback: can i buy cialis in toronto

  401. Pingback: celebrex for joint pain

  402. Pingback: where to buy alendronate

  403. Pingback: keflex for tooth infection

  404. Pingback: where to order cialis

  405. Pingback: levitra how to use

  406. Pingback: cheap nitrofurantoin 100mg

  407. Pingback: wat is het verschil tussen viagra en cialis

  408. Pingback: waar kan ik viagra voor vrouwen kopen

  409. Pingback: cymbalta highest dosage

  410. Pingback: cialis without doctor prescription

  411. Pingback: how much ivermectin to give a dog for worms

  412. Pingback: what type of med is zithromax

  413. Pingback: ivermectin pills for humans

  414. Pingback: cost of glipizide

  415. Pingback: viagra price nz

  416. Pingback: hydroxychloroquine cost per dose

  417. Pingback: tadalafil prices

  418. Pingback: isosorbide australia

  419. Pingback: doxycycline 100 mg capsules cost

  420. Pingback: sildenafil lowest price 20

  421. Pingback: do cialis side effects go away

  422. Pingback: cialis

  423. Pingback: buy cialis online in canada

  424. Pingback: buy viagra cialis online

  425. Pingback: how to buy viagra in usa

  426. Pingback: can i buy cialis in uk

  427. Pingback: azathioprine 50 mg pills

  428. Pingback: cialis without prescription

  429. Pingback: cheap generic cialis

  430. Pingback: propranolol australia

  431. Pingback: viagra without doctor prescription

  432. Pingback: viagra to buy

  433. Pingback: comprar viagra en sevilla

  434. Pingback: what's the difference between tadalafil and viagra

  435. Pingback: indomethacin 75 mg without a doctor prescription

  436. Pingback: canada cialis online

  437. Pingback: best price generic tadalafil 20 mg

  438. Pingback: black viagra 200 mg dose

  439. Pingback: chloroquine over the counter

  440. Pingback: buy cialis online generic

  441. Pingback: essay writing service illegal

  442. Pingback: writing a research paper example

  443. Pingback: write my essay online

  444. Pingback: help me write an argumentative essay

  445. Pingback: buy cialis online in canada

  446. Pingback: business ethics short essay

  447. Pingback: without a doctor prescription viagra

  448. Pingback: dapoxetine generic where to buy

  449. Pingback: india sildenafil

  450. Pingback: cialis buy with visa

  451. Pingback: buy cialis rush

  452. Pingback: hydroxychloroquine mechanism of action

  453. Pingback: hydroxychloroquine news update

  454. Pingback: where to buy tadalafil online

  455. Pingback: lamotrigine tablet

  456. Pingback: ivermectin ontario

  457. Pingback: cheapest levothyroxine mcg

  458. Pingback: buy cialis 36 hour

  459. Pingback: buy cialis online in canada

  460. Pingback: can you buy amoxicillin over the counter usa

  461. Pingback: furosemide pills 20 mg

  462. Pingback: azithromycin australia cost

  463. Pingback: goodrx 100 mg aurogra

  464. Pingback: is there a generic version of tadalafil

  465. Pingback: ivermectin lotion for lice

  466. Pingback: ventolin tablet price

  467. Pingback: online viagra

  468. Pingback: homemade sex on viagra

  469. Pingback: generic cialis cheap

  470. Pingback: otc viagra

  471. Pingback: sildenafil for sale

  472. Pingback: viagra dosages

  473. Pingback: levitra 20 mg

  474. Pingback: liquid viagra

  475. Pingback: cialis information

  476. Pingback: buying cialis online

  477. Pingback: metoprolol 100mg over the counter

  478. Pingback: is acyclovir crushable

  479. Pingback: clotrimazole 10g generic

  480. Pingback: doxycycline hyclate cost

  481. Pingback: prednisolone refrigerated

  482. Pingback: clomid reviews

  483. Pingback: viagra costs

  484. Pingback: cialis reviews by men

  485. Pingback: dapoxetine results

  486. Pingback: viagra gold 800 mg

  487. Pingback: cialis and alcohol

  488. Pingback: viagra accident

  489. Pingback: buy diflucan cheap

  490. Pingback: cheap viagra

  491. Pingback: metoclopramide 10mg generic

  492. Pingback: synthroid side affects

  493. Pingback: liquid cialis

  494. Pingback: generic viagra prices

  495. Pingback: warnings for tadalafil

  496. Pingback: help me write my essay

  497. Pingback: thesis binding service

  498. Pingback: tadalafil for sale on ebay

  499. Pingback: best medical school essay editing service

  500. Pingback: buy cialis online uk

  501. Pingback: dissertation writing service reviews

  502. Pingback: thesis topic

  503. Pingback: how to take cialis 20 mg

  504. Pingback: professional essay writers review

  505. Pingback: india pharmacy hydroxychloroquine

  506. Pingback: genuine viagra for sale

  507. Pingback: custom writing essay service

  508. Pingback: umi dissertation express

  509. Pingback: where can i buy cheap cialis

  510. Pingback: discount propecia

  511. Pingback: cheap essay writers

  512. Pingback: tadalafil online pharmacy india

  513. Pingback: custom written college papers

  514. Pingback: cialis prices walmart

  515. Pingback: sildenafil prices at walgreens

  516. Pingback: usa generic cialis without subscription

  517. Pingback: getting cialis without a prescription

  518. Pingback: cialis 100mg

  519. Pingback: risks of hydroxychloroquine

  520. Pingback: is viagra federally funded

  521. Pingback: cost of sildenafil vs viagra

  522. Pingback: cialis on line purches canadian pharmacy

  523. Pingback: cialis without a doctor prescription

  524. Pingback: purchase cheap cialis

  525. Pingback: who makes viagra

  526. Pingback: viagra before after

  527. Pingback: buy tadalafil online paypal

  528. Pingback: ultram and neurontin

  529. Pingback: define cialis

  530. Pingback: metformin wikipedia

  531. Pingback: can i buy viagra at walgreens australia

  532. Pingback: cost of paxil

  533. Pingback: sildenafil 20 mg price comparison

  534. Pingback: plaquenil company stock

  535. Pingback: canada prescription drugs

  536. Pingback: brand cialis 5 mg

  537. Pingback: amoxicillin dosage for uti treatment

  538. Pingback: costco online pharmacy

  539. Pingback: cialis brand name without prescription

  540. Pingback: tadalafil 5mg cost

  541. Pingback: tadalafil (cialis)

  542. Pingback: is cialis safe for women

  543. Pingback: sildenafil interaction with other drugs

  544. Pingback: coupon for hydroxychloroquine

  545. Pingback: best canadian online pharmacies

  546. Pingback: buy cialis online generic

  547. Pingback: whats better viagra or levitra

  548. Pingback: lasix no prescription

  549. Pingback: prednisone dose pack instructions

  550. Pingback: Prometrium

  551. Pingback: ivermectin at amazon

  552. Pingback: do africans take hydroxychloroquine

  553. Pingback: cost of cialis without insurance

  554. Pingback: canada cialis otc

  555. Pingback: tadalafil 5mg tablets price

  556. Pingback: Tenormin

  557. Pingback: Zakhar Berkut hd

  558. Pingback: Google

  559. Pingback: oxytetracycline generic online

  560. Pingback: 4569987

  561. Pingback: purchase viagra cialis paypal

  562. Pingback: cialis professional legitimate

  563. Pingback: cheapest generic cialis australia

  564. Pingback: how much does cost with insurance

  565. Pingback: news news news

  566. Pingback: faxless cash advance pearland

  567. Pingback: psy

  568. Pingback: psy2022

  569. Pingback: projectio-freid

  570. Pingback: isotretinoin uk online

  571. Pingback: is pink viagra available

  572. Pingback: does viagra make your erection last longer

  573. Pingback: tinderentrar.Com

  574. Pingback: side effects of erythromycin

  575. Pingback: cash advance santa clara

  576. Pingback: Halo Fireteam Raven

  577. Pingback:

  578. Pingback: topvideos

  579. Pingback: video

  580. Pingback: from canada

  581. Pingback: how to find your tinder match on facebook

  582. Pingback: sex toys for women

  583. Pingback: Glock 17 Magazine

  584. Pingback: buy online at lowest price

  585. Pingback: bàn học cho bé

  586. Pingback: itsoktocry viagra

  587. Pingback: buy online at lowest price

  588. Pingback:

  589. Pingback: lovoo online status handy

  590. Pingback: Ukrainskie-serialy

  591. Pingback: site

  592. Pingback: free dating co

  593. Pingback: do you need a prescription to buy cialis

  594. Pingback: is it illegal to buy ativan online

  595. Pingback: how long can you keep cialis

  596. Pingback: cialis back pain

  597. Pingback: free dating site in usa no card needed

  598. Pingback: young adult christian dating

  599. Pingback: top

  600. Pingback: reddit cialis online

  601. Pingback: tricare online pharmacy

  602. Pingback: can i buy cialis without a prescription

  603. Pingback: rx meaning in pharmacy

  604. Pingback: safe canadian pharmacy reviews

  605. Pingback: how to take prednisone 10mg tablets

  606. Pingback: adult

  607. Pingback: bondage toys for couples

  608. Pingback: instant natural bimatoprost

  609. Pingback: נערות ליווי בחיפה

  610. Pingback: viagra 25 mg daily

  611. Pingback: realistic squirting dildo

  612. Pingback: belpre ohio mobile homes for rent

  613. Pingback: cephalexin and vitamins

  614. Pingback: sildenafil 100 mg price

  615. Pingback: guns and ammo

  616. Pingback: bizarre sex toys

  617. Pingback: sex toy reviewer in youtube

  618. Pingback: Glock 43X

  619. Pingback: eskort bayan pendik

  620. Pingback: canadian pharmacy

  621. Pingback: slot online

  622. Pingback: electric motorcycle

  623. Pingback: cialis mastercard

  624. Pingback: sex toy myths and facts

  625. Pingback: adam and eve offer codes

  626. Pingback: cheap generic viagra

  627. Pingback: coupons for albuterol hfa inhaler

  628. Pingback: Gun Shops near me

  629. Pingback: strapon dildo

  630. Pingback: lilly cialis

  631. Pingback: snorting viagra

  632. Pingback: sex games

  633. Pingback: what stds does azithromycin treat

  634. Pingback: rechargeable vibrator

  635. Pingback: warnings for viagra

  636. Pingback: cialis from mexico

  637. Pingback: sildenafil 100mg capsule

  638. Pingback: buy pinball machines online

  639. Pingback: THC Vape Oil

  640. Pingback: PARROTS FOR SALE

  641. Pingback: latest technology. news

  642. Pingback: PULVERIZER

  643. Pingback:

  644. Pingback:

  645. Pingback: how does acyclovir work medically

  646. Pingback: best kratom capsules

  647. Pingback: chelovek-iz-90-h

  648. Pingback: kratom for sale

  649. Pingback:

  650. Pingback: buy Instagram likes

  651. Pingback: best delta 8 thc gummies

  652. Pingback: adam and eve offer codes

  653. Pingback: tides today at

  654. Pingback: Central License For Export

  655. Pingback: bender na4alo 2021

  656. Pingback: blogery_i_dorogi

  657. Pingback: blogery_i_dorogi 2 blogery_i_dorogi

  658. Pingback: THC Gummies

  659. Pingback: where can I buy delta 8

  660. Pingback: weed near me

  661. Pingback: best free dating websites 2021

  662. Pingback: best male masturbator

  663. Pingback: nipple clamps

  664. Pingback: interactions for dapoxetine

  665. Pingback: Google

  666. Pingback: buy weed online

  667. Pingback: buy weed

  668. Pingback: marijuana dispensaries

  669. Pingback: Seattle Weekly

  670. Pingback: weed

  671. Pingback: weed near me

  672. Pingback: shroom supply

  673. Pingback: buy tiktok followers

  674. Pingback: how to buy guns online

  675. Pingback: ruger guns

  676. Pingback: thc vape carts for sale florida

  677. Pingback: hydroxychloroquine for rosacea redness

  678. Pingback: Kelowna moving company

  679. Pingback: Glock Guns for sale

  680. Pingback: Obligasi

  681. Pingback: Takeout

  682. Pingback: MUT

  683. Pingback: hydroxychloroquine package insert

  684. Pingback: MILF Porn Land

  685. Pingback: chernaya vodova

  686. Pingback: istanbul eskortlar

  687. Pingback: tuzla escort

  688. Pingback: hydroxychloroquine deaths per year

  689. Pingback: Roofing Company

  690. Pingback: canadian pharmacies

  691. Pingback: Captain’s Bed

  692. Pingback: Sig Sauer P365

  693. Pingback: Cute Exotic Animals

  694. Pingback: Thc Cartridge

  695. Pingback: Porno

  696. Pingback: vechernyy urgant

  697. Pingback: ukraine

  698. Pingback: 450 bushmaster ammo

  699. Pingback: Squat Rack

  700. Pingback: whole king crab for sale

  701. Pingback: novartis ciprodex coupon

  702. Pingback: how to burn belly fat

  703. Pingback: A3ixW7AS

  704. Pingback: garden sheds near me

  705. Pingback: adam and eve

  706. Pingback: poarol

  707. Pingback: visit website

  708. Pingback: gidonline-ok-google

  709. Pingback: software reviewer

  710. Pingback: Cryptocurrency HBCUC

  711. Pingback: juul pods for sale

  712. Pingback: Buy Guns Online USA

  713. Pingback: link

  714. Pingback: canada pharmacy canada pharmacy

  715. Pingback: معرفة هوية المتصل

  716. Pingback: buy cheap weed online

  717. Pingback: buy medical marijuana online in usa

  718. Pingback: buy glo extracts carts online

  719. Pingback: Buy Ruger Guns Online

  720. Pingback: KremlinTeam

  721. Pingback:

  722. Pingback:

  723. Pingback:

  724. Pingback:

  725. Pingback: canada pharmacy

  726. Pingback: ptsd

  727. Pingback: Buy Cocaine Online

  728. Pingback: Suicide Squad 2

  729. Pingback: Laptop hilfe meilen

  730. Pingback: about

  731. Pingback: psiholog

  732. Pingback: Symptoms of Prostate Cancer

  733. Pingback: male pocket stroker

  734. Pingback: penis enlarger

  735. Pingback: g spot vibrator review

  736. Pingback: flomax and cialis

  737. Pingback: penis vacuum pumps

  738. Pingback: audio sex

  739. Pingback: over the counter viagra walmart

  740. Pingback: cvs pharmacy inside target store near me

  741. Pingback: hizhnyak-07-08-2021

  742. Pingback: catalca escort

  743. Pingback: get viagra prescribed online

  744. Pingback: canada pharmacy canada pharmacy

  745. Pingback: free online pharmacy technician training

  746. Pingback: Heroin For Sale

  747. Pingback: politics

  748. Pingback:

  749. Pingback: magic wand massager

  750. Pingback: happyluke

  751. Pingback: pharmacy rx one order status

  752. Pingback: natural viagra alternatives

  753. Pingback: best male stroker

  754. Pingback: adam and eve online store

  755. Pingback:

  756. Pingback: best way to clean silicone sex toys

  757. Pingback: taksim escort

  758. Pingback: sinirsiz escort

  759. Pingback: ทางเข้า happyluke

  760. Pingback: ben wa balls review

  761. Pingback: how dangerous is ivermectil

  762. Pingback: Magic Mushroom Vancouver

  763. Pingback:

  764. Pingback: rabbit thrusting vibrator

  765. Pingback: gay sex toys

  766. Pingback: p spot stimulation

  767. Pingback: mersin escort

  768. Pingback: Vietnamese Restaurant

  769. Pingback: buy exotic weed

  770. Pingback: fun88

  771. Pingback: prostate vibrator

  772. Pingback: wireless remote panties

  773. Pingback: male stroker toy

  774. Pingback: best cheap battery operated vibrators

  775. Pingback: Inogen g2 for sale

  776. Pingback: powerful vibrator

  777. Pingback: visit website

  778. Pingback: Male Masturbator

  779. Pingback: lottovip สมัคร

  780. Pingback: hosting deals

  781. Pingback: ground lease

  782. Pingback: lottovip สมัคร

  783. Pingback: สมัคร ruay

  784. Pingback: best p spot vibrators

  785. Pingback: male masturbator review

  786. Pingback: realistic dildo

  787. Pingback: how to masturbate using a dildo

  788. Pingback: Arkamk

  789. Pingback: Thc jull pods

  790. Pingback: 99defi p2p network

  791. Pingback: sariyer escort

  792. Pingback: site de streaming

  793. Pingback: reliable car transport

  794. Pingback: french streaming

  795. Pingback: film streaming

  796. Pingback: sites para ver futebol

  797. Pingback: norvasc tablet

  798. Pingback: CTRLCOIN

  799. Pingback: download a twitter video

  800. Pingback: best male masturbator

  801. Pingback: what is omeprazole generic for

  802. Pingback: klonopin and prozac

  803. Pingback: sex education facts

  804. Pingback: withdrawal from seroquel

  805. Pingback: anal toys

  806. Pingback: how to achieve orgasm using a penis ring

  807. Pingback: adam and eve female vibrator

  808. Pingback: stromectol for river blindness

  809. Pingback: male masturbator review

  810. Pingback: 1xbit app

  811. Pingback: sertraline and diarrhea

  812. Pingback: best in ottawa

  813. Pingback: hansraj model school student login

  814. Pingback: is it best to take escitalopram/lexapro at night or day

  815. Pingback: duloxetine (cymbalta) how many people are on

  816. Pingback: stoeger m3000 for sale

  817. Pingback: 메이저놀이터

  818. Pingback: 피망머니상

  819. Pingback: buy real viagra online

  820. Pingback: canadian pharmacy viagra

  821. Pingback: vidalista tadalafil black 800

  822. Pingback: русские книги в сша

  823. Pingback: buying generic viagra online

  824. Pingback: buy sildenafil online

  825. Pingback: How to Book a Safari to Murchison Falls Uganda?

  826. Pingback: buy sildenafil

  827. Pingback: tena lady

  828. Pingback: how to purchase cialis

  829. Pingback: stromectol goodrx

  830. Pingback: big chief napalm og price

  831. Pingback: albuterol inhaler hfa 90 base

  832. Pingback: rx cialis

  833. Pingback: lexapro dizziness

  834. Pingback: brand cialis

  835. Pingback: buy cialis tablets

  836. Pingback: where can you buy cialis

  837. Pingback: Thc vape cartridges

  838. Pingback: cialis 10 mg

  839. Pingback: NAPHYRONE FOR SALE

  840. Pingback: ivermectay 6 mg

  841. Pingback: West Highland White Terrier puppies for sale

  842. Pingback: cheap cialis brand

  843. Pingback: Duna 2021

  844. Pingback: cheap viagra online canadian pharmacy

  845. Pingback: St Francis Church of England Aided Primary School and Nursery

  846. Pingback: about canada pharmacy

  847. Pingback: types of plaquenil

  848. Pingback: canadian generic viagra

  849. Pingback: vibrator

  850. Pingback: sex toys for guys

  851. Pingback: projektant wnętrz Gdynia

  852. Pingback: 1

  853. Pingback: بديل تروكولر

  854. Pingback: cymbalta for chronic pain

  855. Pingback: pc apps for windows 7

  856. Pingback: viagra otc

  857. Pingback: apps for pc download

  858. Pingback: games for pc download

  859. Pingback: free download for windows 8

  860. Pingback: free download for windows xp

  861. Pingback: free download for pc windows

  862. Pingback: generic for cialis tadalafil

  863. Pingback: mp3 juice download

  864. Pingback: download app apk for windows pc

  865. Pingback: otc viagra

  866. Pingback: viagra over the counter uk price

  867. Pingback: Devis site Wordpress

  868. Pingback: ivermectin 125 mg

  869. Pingback: Sig Sauer Guns For Sale

  870. Pingback: IT Services Bridgwater

  871. Pingback: can i buy viagra online legally

  872. Pingback: will amoxicillin treat bv

  873. Pingback: tadalafil 5mg price

  874. Pingback: viagraherse

  875. Pingback: viagra generic

  876. Pingback: Pinball Machines for Sale

  877. Pingback: Gorilla trekking 

  878. Pingback: Livestock for sale

  879. Pingback: Macbook air akku bubikon

  880. Pingback: cialis for women

  881. Pingback: propecia body hair

  882. Pingback: Bes of Uganda gorilla wildlife safari

  883. Pingback: 5mg prednisone daily

  884. Pingback: best sex toys


  886. Pingback: online viagra prescription

  887. Pingback: shipping containers for sale

  888. Pingback: Serengeti African safari

  889. Pingback: ارقام بنات

  890. Pingback: aromatherapy

  891. Pingback: buy cialis online without a prescription

  892. Pingback: buy viagra soft online

  893. Pingback: strength of ivermectin tablets

  894. Pingback: generic viagra online no prescription

  895. Pingback: 30 mg sildenafil buy online

  896. Pingback: ivermectin pill

  897. Pingback: Izrada web sajta Crna Gora

  898. Pingback: lowes kronos server

  899. Pingback: how do i get cialis

  900. Pingback: fleet farm ivermectin

  901. Pingback: zithramax online overnight

  902. Pingback: how much ivermectin paste to give a dog for mange

  903. Pingback: durvet ivermectin paste

  904. Pingback: can i buy ventolin over the counter in usa

  905. Pingback: Buy Morphine pills online

  906. Pingback: buy sildenafil 20 mg

  907. Pingback: ivermectin skin rash

  908. Pingback: brand viagra 100 mg best price

  909. Pingback: CANNABIS PUFF BAR

  910. Pingback: ivermectin scabies dosage

  911. Pingback: ivermectin to treat covid

  912. Pingback: low cost alternatives to viagra

  913. Pingback: benelli nova 18 inch barrel

  914. Pingback: savage impulse hog hunter 300 win

  915. Pingback: buy sig p365

  916. Pingback: taurus pt92 stainless

  917. Pingback: how to buy viagra tablets in pakistan

  918. Pingback: hee haw slot machines for sale

  919. Pingback: dr rajter ivermectin

  920. Pingback: mossberg mvp 308 stock for sale

  921. Pingback: le tadalafil

  922. Pingback: pentobarbital for sale

  923. Pingback: magic mushrooms

  924. Pingback: magic mushrooms

  925. Pingback: cheapest generic cialis uk

  926. Pingback: tadalafil side effects

  927. Pingback: zithromax and bronchitis

  928. Pingback: places to buy viagra

  929. Pingback: order weed online eu

  930. Pingback: background check

  931. Pingback: viagra receptfritt

  932. Pingback: otc ed drugs

  933. Pingback: sildenafil

  934. Pingback: mint juul pods

  935. Pingback: is it better to take lisinopril twice a day

  936. Pingback: beretta 92 elite ltt for sale

  937. Pingback: payday advance san diego

  938. Pingback: canadian marble fox for sale

  939. Pingback: cockatoo for sale

  940. Pingback: s&w 586 l comp for sale

  941. Pingback: stromectol dosing by weight

  942. Pingback: blue recliner

  943. Pingback: natural viagra

  944. Pingback: super p force dapoxetine

  945. Pingback: buy weed online usa

  946. Pingback: buy graphics card online usa

  947. Pingback: Capuchin Monkey For Sale

  948. Pingback: Budget Safari to Murchison Falls

  949. Pingback: 3080 ftw3 msrp

  950. Pingback: gym equipments online

  951. Pingback: وكالة تسويق

  952. Pingback: Henry Youth Lever-Action Rimfire 

  953. Pingback: G19 COMPACT | 9X19MM

  954. Pingback: stock market 101

Comments are closed.