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Monday, June 1, 2015

Guest Post - Perhaps Paramedics Should NOT Intubate!


What if we're wrong? What if the "gold standard" for airway management is not approriate for EMS personnel? Even though many of us spent  untold hours training to perform ET intubation, and have felt justifiable pride in performing this skill well, is it possible that our efforts have been (ahem) misplaced?

This is a guest post by Ben Dowdy, NRP, exploring this unpopular position, reevaluating the opposite perspective. This is part of the inaugural "What-if-We’re-Wrong-a-Thon" organized by Brandon Oto of EMS Basics fame (and soon-to-be lead author in a Very Important Journal).


The continued role of endotracheal intubation as a standard prehospital skill continues to be debated, sometimes hotly.  I’m going to present an argument against prehospital endotracheal intubation.
Aspiration Prevention
Proponents of endotracheal intubation often use the argument that ET intubation protects the airway from aspiration.  But how true is such a claim?  Multiple studies of emergency airway management list aspiration as an infrequent complication 1,2, only occurring 2.8-3.5% of the time.  A study of prehospital RSI3 found that pre-intubation evidence of aspiration was noticed in a significant number of patients, but only one incidence of peri-intubation aspiration was recorded, and no instances of post-intubation aspiration were reported.
What to make of this?  Aspiration pneumonia is a serious diagnosis, conferring an adjusted 2.3 odds ratio in favor of mortality4.  But for the majority of patients having their airway managed in the prehospital field, if aspiration is going to occur, it’s extremely likely that it happens prior to EMS providers arriving and managing the airway.  A prehospital ET tube prevents aspiration very uncommonly.
No Mortality Benefit
As EMS evolves, we’re constantly being challenged to ensure that our treatments and procedures have meaningful, patient-oriented outcomes.  As I heard it referred to early in my paramedic career, “we should be doing things for patients, not to them.”  For prehospital intubation, unfortunately, that does not appear to be the case.  The available literature investigating prehospital intubation’s effects on mortality5-9 overwhelmingly show that if trauma patients are alive when they’re intubated in the field, their chance of dying just increased.  For patients who are already in cardiac arrest, evidence is conflicting as to whether ANY advanced airway management improves mortality, and even then the champion between supraglottic airways and endotracheal intubation varies with almost every new study that comes out.
Can EMS Education Programs Assess Competency in Intubation?
Initial requirements for intubation training in EMS used to be laughable under the National Standard Curriculum; 5 intubations was all you needed, compared with 50+ in medical schools.  The National EMS Education Standards thankfully replaced this with the more blanket term of “demonstrating competency” during providers’ initial training programs, allowing educational institutions to set the bar higher to ensure that new paramedics could competently intubate patients.  However, this higher standard has created difficulties.  A series of surveys10 distributed by the Committee for Accreditation of EMS Programs (CoAEMSP) found that 53% of programs have difficulty obtaining access to ORs for students to practice; 81% use high-fidelity simulators to determine competency and 90.7% urged CoAEMSP to allow these simulators as a means of demonstrating competency.  In others words, most EMS education institutions can’t ensure that their paramedic graduates will ever intubate an actual person, even a stable one undergoing elective surgery, prior to getting their certification or licensure.  To add even greater concern, the available airway mannequins commonly used in EMS airway training (including the ones that most programs want to use to “prove” competency) correlate extremely poorly with airway measurements of actual people11.
Summary
Endotracheal intubation is a skill that’s difficult to master; it takes a lot of realistic practice during initial education and at frequent intervals afterwards to be able to succeed in prehospital settings.  Our education institutions can’t guarantee that providers entering the field can competently intubate patients.  The common argument of “aspiration protection” is a false one; aspiration doesn’t occur very often at all during emergency airway management, it occurs before we ever show up.  When we intubate people, their mortality rate increases.  It’s time to stop using endotracheal intubation as a first-line airway management technique until we can prove that we’re doing it for our patients, instead of to them.
References
1.     Thibodeau LG, et al (1997).  “Incidence of Aspiration after Urgent Intubation.”  Am J Emerg Med. 1997 Oct;15(6):562-5.
2.     Martin LD, et al (2011).  3,423 emergency tracheal intubations at a university hospital: airway outcomes and complications.”  Anesthesiology. 2011 Jan;114(1):42-8.
3.     Vadeboncoeur TF, et al (2006).  The ability of paramedics to predict aspiration in patients undergoing prehospital rapid sequence intubation.”  J Emerg Med. 2006 Feb;30(2):131-6
4.     Lanspa MJ, et al (2015).  “Characteristics associated with clinician diagnosis of aspiration pneumonia: a descriptive study of afflicted patients and their outcomes.”  J Hosp Med.  2015 Feb; 10(2):90-6.
5.     Evans CC, et al (2013).  “Prehospital non-drug assisted intubation for adult trauma patients with Glasgow Coma Score less than 9.”  Emerg Med J. 2013 Nov;30(11):935-41.
6.     Karamanos E, et al (2014).  “Is prehospital endotracheal intubation associated with improved outcomes in isolated severe head injury?  A matched cohort analysis.”  Prehosp Disaster Med. 2014 Feb;29(1):32-6.
7.     Taghavi S, et al (2014).  “Prehospital intubation does not decrease complications in the penetrating trauma patient.”  Am Surg. 2014 Jan;80(1):9-14.
8.     Kempema J, et al (2015).  Prehospital endotracheal intubation vs. extraglottic airway device in blunt trauma.”  Am J Emerg Med. 2015 Apr 29.
9.     Stockinger ZT, McSwain NE Jr. (2004).  “Prehospital endotracheal intubation for trauma does not improve survival over bag-valve-mask ventilation.”  J Trauma. 2004 Mar;56(3):531-6.
10.  Kalish, MA (2013).  “Definition of Airway Competency.”  http://coaemsp.org/Documents/Airway-Competency-Kalish-2013-09.pdf
11.  Schebesta K, et al (2012).  “Degrees of reality: Airway Anatomy of High-fidelity Human Patient Simulators and Airway Trainers.”  Anesthesiology.  2012 June;116(6):1204-9.
Bio: Ben Dowdy B.S., NRP, is a paramedic and EMS educator currently working in northern Idaho.  His past experiences include working as a paramedic, tactical paramedic, and SAR medic in urban, rural, and wilderness areas, including Yellowstone National Park, and teaching EMS topics for a university-based EMS education program, as well as across the US and abroad for Wilderness Medical Associates.

144 comments:

  1. I would just like to comment that my medical school required ZERO intubations to successfully graduate. The vast majority of my airway management training and experience came from my time as a prehospital provider. I performed about 30 intubations as a medical student purely due to an anesthesia elective I chose to do while many of my classmates did none. Additionally, I am glad that some things in medicine and EMS in particular are moving towards evidence based recommendations, but I am certain that we are going to start taking away interventions from subsets of patients who would benefit from them. Despite well designed studies, there are going to be particular patients who benefit from a treatment despite statistical evidence to the contrary. There will be patients for whom the most appropriate airway intervention is endotracheal intubation. Our efforts now should be defining those particular populations and ensuring the skill sets of paramedics old and new are top notch, not heavy-handily prohibiting procedures.

    ReplyDelete
    Replies
    1. Good to hear from a Downeaster!

      I'll emphasize that this is Ben's essay, but the ET question is tough. As the frequency of a procedure goes down, the risk of inappropriate patient selection goes up, procedural complications get more common, and the whole risk:benefit calculation gets trickier.

      Take the example of trauma thoracostomy. Is it a bad thing that medics do not perform this very low frequency (but high acuity) procedure? Certainly there are subsets of patients that would benefit from a quick prehospital thoracostomy, but few systems will see a benefit in training for, and maintaining, proficiency in this skill.

      So, is ET intubation becoming more like thoracostomy, or will it continue to be an essential EMS skill like BVM?

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  2. Another thought provoking post. It seems to be throwing the baby out with the bathwater though. Seriously though, how am I ever supposed to give epi in cardiac arrest if we can't intubate?!

    "It’s time to stop using endotracheal intubation as a first-line airway management technique." Stop it. Right there. That's all you need to say. Don't remove the skill. Don't say paramedics shouldn't perform the skill. We need to stop referring to intubation as the gold standard for airway management. An airway the oxygenates, and ventilates, is the gold standard for airway maintenance. If we keep perpetuating the belief that intubation is the gold standard for airway management, then we will continue to have this debate. Nowhere is this better illustrated than in the OR rotations dilemma. You know what else you miss out on when you don't attend the OR? Mask ventilation on a live patient. LMA insertion on a live patient. Sedation and analgesia on a live patient.

    Additionally, I am yet to find any learning theory that places competency at the same level as mastery. Competency doesn't even signify proficiency. Pick any skill, in any discipline, taught in any initial education program. You don't walk out the door as a master plumber or a master electrician. Why is EMS any different?

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  4. Well explained the different aspects of ET incubation. You have made some good points over here. As you said, Endotracheal intubation is a skill that’s difficult to master. I agree with this point. Essay writing service

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  5. Allow me to play Devil's advocate here, poorer outcomes do not always mean poor care. Given proper use of ETCO2 for airway management and CPAP to try and eliminate unnecessary intubations it would lead one to look at the fact that these patients are likely sicker than the average patient. I do think we need to remove any stigma from choosing an effective SGA over ET Intubation in the field though. Right tool at the right time, as it were. I will say not all Medics should be intubating and video laryngeosopy should be the standrd of care as well.

    ReplyDelete
  6. I have tubed numerous patients in the field, but each intubation is pretty close to a death sentence as very few patients ever made it out of the hospital. Intubation becomes a stumbling block for paramedics in cardiac arrest as they get tunnel vision towards getting a tube and less intersted in performing good CPR. What could you not accomplish better and easier with an LMA or dual lumen airway device?

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    7, Tiredness
    8, Swollen lymph glands
    9, Pneumonia
    10, Memory loss
    11, Depression
    12, Swelling of the lymph glands
    13, Red, brown, pink spots on the skin, mouth, nose, or eyelids
    14, Sores of the mouth, anus, or genitals
    15' HIV/AIDS
    16' Herpes virus
    17, Penis Enlargement
    18, Hepatitis AB and C
    19, Diabetes
    20, Ulcer

    ReplyDelete
  23. The continued role of endotracheal intubation as a standard prehospital skill continues to be debated, sometimes hotly ty le ca cuoc. I’m going to present an argument against prehospital endotracheal intubation bet69 .

    ReplyDelete
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  25. Chinese Celebrities Hot Images, Hot Photos, Hot Pics just visit this website given below.

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  26. I Want To Appreciate Dr.OYAGU for hs great deeds, I Was Diagnosed With type 2 Herpes Virus Last year,And Was Look For Solution To Be Cured Luckily I Saw Testimonies On How Dr.OYAGU Cure Herpes Virus I Decided To Contact Dr.OYAGU I Contacted Him He Prepared A Herbal Medicine Portion And Sent It To Me,I Started The Herbal Medicine For My Health.He Gave Me Step By Step Instructions On How To Apply It, When I Applied It As Instructed, I Was Cured Of This Deadly Herpes Within 2 weeks, I Am Now Herpes Negative.My Brother And Sister I No That There Are So Many People That Have There Same Herpes Virus Please contact Dr OYAGU To Help You Too,And Help Me To Thank Dr.OYAGU For Cure Me, I’m Cured By Dr. OYAGU Herbal Medicine,His Contact Email:oyaguspellcaster@gmail.com

    Or Cell Whatsapp Number +2348101755322 thank you .....

    ReplyDelete
  27. I Want To Appreciate Dr.OYAGU for hs great deeds, I Was Diagnosed With type 2 Herpes Virus Last year,And Was Look For Solution To Be Cured Luckily I Saw Testimonies On How Dr.OYAGU Cure Herpes Virus I Decided To Contact Dr.OYAGU I Contacted Him He Prepared A Herbal Medicine Portion And Sent It To Me,I Started The Herbal Medicine For My Health.He Gave Me Step By Step Instructions On How To Apply It, When I Applied It As Instructed, I Was Cured Of This Deadly Herpes Within 2 weeks, I Am Now Herpes Negative.My Brother And Sister I No That There Are So Many People That Have There Same Herpes Virus Please contact Dr OYAGU To Help You Too,And Help Me To Thank Dr.OYAGU For Cure Me, I’m Cured By Dr. OYAGU Herbal Medicine,His Contact Email:oyaguspellcaster@gmail.com

    Or Cell Whatsapp Number +2348101755322 thank you .....

    ReplyDelete
  28. I Want To Appreciate Dr.OYAGU for hs great deeds, I Was Diagnosed With type 2 Herpes Virus Last year,And Was Look For Solution To Be Cured Luckily I Saw Testimonies On How Dr.OYAGU Cure Herpes Virus I Decided To Contact Dr.OYAGU I Contacted Him He Prepared A Herbal Medicine Portion And Sent It To Me,I Started The Herbal Medicine For My Health.He Gave Me Step By Step Instructions On How To Apply It, When I Applied It As Instructed, I Was Cured Of This Deadly Herpes Within 2 weeks, I Am Now Herpes Negative.My Brother And Sister I No That There Are So Many People That Have There Same Herpes Virus Please contact Dr OYAGU To Help You Too,And Help Me To Thank Dr.OYAGU For Cure Me, I’m Cured By Dr. OYAGU Herbal Medicine,His Contact Email:oyaguspellcaster@gmail.com

    Or Cell Whatsapp Number +2348101755322 thank you .....

    ReplyDelete
  29. I'm 59 years old and female. I was diagnosed a couple of years ago with COPD and I was beyond scared! My lung function test indicated 49% capacity. After having had flu a year ago, the shortness of breath, coughing and chest pains continued even after being treated with antibiotics. I've been smoking two packs a day for 36 years. Being born without a sternum caused my ribs to be curled in just one inch away from my spine, resulting to underdeveloped lungs. At age 34 I had surgery and it was fixed. Unfortunately my smoking just caused more damage to my already under developed lungs. The problem was having is that I enjoy smoking and don't want to give up! Have tried twice before and nearly went crazy and don't want to go through that again. I saw the fear in my husband and children's eyes when I told them about my condition then they start to find solution on their own to help my condition.I am an 59 now who was diagnose COPD emphysema which I know was from my years of smoking. I started smoking in school when smoking was socially acceptable. I remember when smoking was permitted in hospitals. It was not known then how dangerous cigarettes were for us, and it seemed everybody smoked but i was able to get rid of my COPD lung condition through the help of total cure herbal foundation my husband bought, totalcureherbsfoundation .c om has the right herbal formula to help you get rid and repair any lung conditions and cure you totally with their natural organic herbs. I wish anybody who starts smoking at a young age would realize what will eventually happen to their bodies if they continue that vile habit throughout their life.

    ReplyDelete
  30. Hello! I'm very excited to inform everyone that I'm completely cured from my HSV 1&2 recently. I have used Oregano oil, Coconut oil, Acyclovir, Valacyclovir, Famciclovir, and some other products and it's really help during my outbreaks but I totally got cured! from my HSV with a strong and active herbal medicine ordered from a powerful herbalist and it completely fought the virus from my nervous system and I was tested negative after 12 days of using the herbal medicine. I'm here to let y'all know that herpes virus has a complete cure, I got rid of mine with the help of Dr Emmanuel and his herbal exploit. Contact him via email: nativehealthclinic@gmail.com or Call/WhatsApp him at +2348140073965
     thank you..

    ReplyDelete
  31. am so happy to share this great testimony and also say a big thanks to Dr okeke for what he have done for me! with his love spell am Lisa Steven from Canada. Dr okeke has given me a reason to be happy again my husband who lift me and our kids and requested for a divorce has come back home with the help of Dr okeke I have not been myself since my husband tell me he wants a divorce a day came when i was reading about divorce on the internet i come across a great testimony on websit posted by laura and say good things about this great Dr okeke how he help her restore her marriege i said to myself if this truth or what I said let me give a try i contacted Okeke and told him to help me stop the divorce with my husband and bring him back home and okeke told me what i need to do and I did it Okeke call me again to tell me that my husband will be coming back home within 3 days sometimes things you don't believe can just happens right now my husband has come back home and stopped to fill the divorce papers after i contacted Dr okeke to help me stop the divorce with my husband and now things are going much better. As Dr okeke said, all the process concerning the divorce have been cancelled and the evil woman that cause the problem in my marriage has also sent away by my husband and we are now happy together again. i said it better for me to share this good news and good work of Dr okeke with everyone here I know many people are in similar problem in one way or the other in your marriage or relationship reach Dr okeke today his the solution to your problem and predicament Dr okeke is the most very powerful trusted spell caster i have come across with once again Thank you okeke for your help reach him on email at (writelovespell@gmail.com) or chat him on WhatsApp on (+2348140443360) Also specialize in treating all kinds of illness, HERPES VIRUS, HEPATITIS B, CANCER, BRAIN DISEASE, INFERTILITY, DIABETES, PREGNANCY SPELL AND MORE

    ReplyDelete
  32. Thank GOD for My Life, i am so glad to writing this article today to tell the world how Dr oso cured my HSV VIRUS,i have been detected with HSV-1 AND HSV-2 since 3 years ago, ever since then my life has been in complete bizarre and agony,i have used so many drugs that was prescribed to me by several doctors,but it didn't cure my HSV VIRUS neither did it reduce the pain,until a certain i was checking for solution in the internet,then miraculously came across Dr oso the powerful herbalist that cure numerous individuals HSV-1 AND HSV-2 INFECTION,then i contacted his whatsApp number at +2348162084839 or email: drosohaberhome@gmail.com i explained everything to him and he prepared a cure, that cure my HSV-1 AND HSV-2 disease totally after receiving his herbal medicine, so my friends viewers why wait and be suffer when there is someone like Dr OSO  that can cure any disease HIV/ CANCER/ HEPATITIS B VIRUS, you can contact his via : drosohaberhome@gmail.com. or WHATSAPP +2348162084839  GOD BLESS YOU ALL? .
    .  
    here is the  DR OSO website. 

    https://sites.google.com/view/drosohaberhome/

    His blog
    page https://drosohaberhome.blogspot.com

    you can also email me for more information about DR oso via johnlizzy498@gmail.com ALL THANK TO DR OSO .

    ReplyDelete
  33. Check MOT History online to check the MOT status of any Car/MOT or Vehicle. MOT History helps you to know about your vehicle if you are going to buy it. You have to know about all the details of MOT or Vehicle before buying. Check MOT History now for free.

    ReplyDelete
  34. i want to inform the public how i was cured of HERPES Simplex Virus by a Doctor called Dr.EBHOTA. i visited different hospital but they gave me list of drugs like Famvir, Zovirax, and Valtrex which is very expensive to treat the symptoms and never cured me. I was browsing through the Internet searching for remedy on HERPES and i saw comment of people talking about how Doctor EBHOTA cured them. I Was scared because i never believed in the Internet but i was convince to give him a try because i was having no hope of been cured of HERPES so i decided to contact him on his email, i searched his email on net and i saw a lot of people testifying about his goodness. when i contacted him he gave me hope and send a Herbal medicine to me that i took and it seriously worked for me, am a free person now without problem, my HERPES result came out negative. You can contact him on
    his Email: drebhotasolution@gmail.com or whatsapp him on +2348089535482 and get all your problem solved.
    1Sickness of any kind
    2 Help to CURE Hepatitis B, HIV/AIDs CANCER and BIPOLAR
    3 Divorce, Breakup problem and To Re-unit
    4 Pregnancy problem
    5 Financial problem and Job promotion
    6 To get a good and rich life partner
    7 To Lose your wath
    8 to enlargement of pennis
    9. CANCER
    10. ALS (Lou Gehrig's disease)
    11 Hepatitis B
    12 chronic pancreatic
    13 emphysema
    14 COPD (chronic obstructive pulmonary disease)   

    ReplyDelete
  35. i want to inform the public how i was cured of HERPES Simplex Virus by a Doctor called Dr.EBHOTA. i visited different hospital but they gave me list of drugs like Famvir, Zovirax, and Valtrex which is very expensive to treat the symptoms and never cured me. I was browsing through the Internet searching for remedy on HERPES and i saw comment of people talking about how Doctor EBHOTA cured them. I Was scared because i never believed in the Internet but i was convince to give him a try because i was having no hope of been cured of HERPES so i decided to contact him on his email, i searched his email on net and i saw a lot of people testifying about his goodness. when i contacted him he gave me hope and send a Herbal medicine to me that i took and it seriously worked for me, am a free person now without problem, my HERPES result came out negative. You can contact him on
    his Email: drebhotasolution@gmail.com or whatsapp him on +2348089535482 and get all your problem solved.
    1Sickness of any kind
    2 Help to CURE Hepatitis B, HIV/AIDs CANCER and BIPOLAR
    3 Divorce, Breakup problem and To Re-unit
    4 Pregnancy problem
    5 Financial problem and Job promotion
    6 To get a good and rich life partner
    7 To Lose your wath
    8 to enlargement of pennis
    9. CANCER
    10. ALS (Lou Gehrig's disease)
    11 Hepatitis B
    12 chronic pancreatic
    13 emphysema
    14 COPD (chronic obstructive pulmonary disease)   

    ReplyDelete
  36. FINALLY FREE FROM HERPES VIRUSI thought my life had nothing to offer anymore because lifebecame meaningless to me because I had Herpes virus, thesymptoms became very severe and bold and made my familyrun from and abandoned me so they won't get infected. I gaveup everything, my hope, dreams,vision and job because thedoctor told me there's no cure. I consumed so many drugs butthey never cured me but hid the symptoms inside me makingit worse. I was doing some research online someday when Icame across testimonies of some people of how DR Ebhotacured them from Herpes, I never believed at first and thoughtit was a joke but later decided to contact him on the detailsprovided and when I messaged him we talked and he sent mehis herbal medicine and told me to go for a test after twoweeks. Within 7 days of medication the symptomsdisappeared and when I went for a test Lo and behold I wasNEGATIVE by the Doctor Who tested me earlier. Thank you DREbhota because I forever owe you my life and I'll keep ontelling the world about you. If you are going through samesituation worry no more and contact DR Ebhota viadrebhotasolution@gmail. com or WhatsApp him via +2348089535482.he also special on cureing 1. HIV/AIDS2. HERPES 3. CANCER 4.ALS 5. HEPATITIS B 6.DIABETES 7. HUMAN PAPILOMA VIRUS DISEASE(HPV)8. ALZHEIMER 9. LUPUS (Lupus Vulgaris or LupusErythematosus 

    ReplyDelete
  37. FINALLY FREE FROM HERPES VIRUSI thought my life had nothing to offer anymore because lifebecame meaningless to me because I had Herpes virus, thesymptoms became very severe and bold and made my familyrun from and abandoned me so they won't get infected. I gaveup everything, my hope, dreams,vision and job because thedoctor told me there's no cure. I consumed so many drugs butthey never cured me but hid the symptoms inside me makingit worse. I was doing some research online someday when Icame across testimonies of some people of how DR Ebhotacured them from Herpes, I never believed at first and thoughtit was a joke but later decided to contact him on the detailsprovided and when I messaged him we talked and he sent mehis herbal medicine and told me to go for a test after twoweeks. Within 7 days of medication the symptomsdisappeared and when I went for a test Lo and behold I wasNEGATIVE by the Doctor Who tested me earlier. Thank you DREbhota because I forever owe you my life and I'll keep ontelling the world about you. If you are going through samesituation worry no more and contact DR Ebhota viadrebhotasolution@gmail. com or WhatsApp him via +2348089535482.he also special on cureing 1. HIV/AIDS2. HERPES 3. CANCER 4.ALS 5. HEPATITIS B 6.DIABETES 7. HUMAN PAPILOMA VIRUS DISEASE(HPV)8. ALZHEIMER 9. LUPUS (Lupus Vulgaris or LupusErythematosus 

    ReplyDelete
  38. WHAT A GREAT MIRACLE THAT I HAVE EVER SEE IN MY LIFE. My names are Clara David I’m a citizen of USA, My younger sister was sicking of breast cancer and her name is Sandra David I and my family have taking her to all kind of hospital in USA still yet no good result. I decided to go to the internet and search for cancer cure so that was how I find a lady called peter Lizzy she was testifies to the world about the goodness of a herbal man who has the roots and herbs to cure all kind of disease and the herbal man email was there. So I decided to contact the herbal man u/herbalist_sakura for my younger sister help to cure her breast cancer. I contacted him and told him my problem he told me that I should not worry that my sister cancer will be cure, he told me that there is a medicine that he is going to give me that I will cook it and give it to my sister to drink for one week, so I ask how can I receive the cure that I am in USA, he told me That I will pay for the delivery service. The courier service can transport it to me so he told me the amount I will pay, so my dad paid for the delivery fee. two days later I receive the cure from the courier service so I used it as the herbal man instructed me to, before the week complete my sister cancer was healed and it was like a dream to me not knowing that it was physical I and my family were very happy about the miracle of Doctor so my dad wanted to pay him 5 million us dollars the herbal man did not accept the offer from my dad, but I don't know why he didn't accept the offer, he only say that I should tell the world about him and his miracle he perform so am now here to tell the world about him if you or your relative is having any kind of disease that you can't get from the hospital please contact dr.sakuraspellalter@gmail.com or whats app him +2348110114739 you can follow him up on Instagram u/herbalist_sakura for the cure, he will help you out with the problem. And if you need more information about the doctor you can mail me davidclara223@gmail.com

    ReplyDelete
  39. I'm Celina Gomez from Canada, i have been cured from genital herpes with herbalist Sakura herbal Remedy.
    i have been infected with genital herpes for 1 years now , i have done so many medical treatment from different hospital still
    not cured. On a very good day , i decided to make a research on my computer on how to get rid of genital herpes,i found a post of Sarah Wilson on how she was  cured from herpes with herbalist Dr sakura  herbal remedy.
    The Herbalist email/contact number  was there as well dr.sakuraspellalter@gmail.com/ +2348160802189. i contacted him because of my illness .He needed few of my information which i did, and also send me his medicine through FedEx courier service.
    which i received  after 3 working  days of shipment,i drink the  herbal medicine the same way Herbalist Dr Sakura instructed me too.but now my genital herpes is gone totally without any side effect or harm, may God Almighty continuing to bless him abundantly .
    you can contact him on mail/whats app dr.sakuraspellalter@gmail.com +2348110114739 or follow him on Instagram @Herbalist_sakura .you can also mail me for more information celinagomez784@gmail.com

    ReplyDelete
  40. I have suffered with herpes since I was young it is only the last few years I got to know so I started to look for a cure I went to several hospitals but to no avail. So I came here online to see if I could find a cure so I came across a page here a man was sharing testimonies about Dr Ohikhobo for his natural herbs cure for herpes so I decided to give it a try it only took two weeks of me taking his herbs and I was completely cured from herpes. contact Dr Ohikhobo today if you want to be cured from herpes or any kind of disease too . I am so grateful red with herpes since I was young it is only the last few years I goto this man
    His Email: drohikhoboherbalcenter@gmail.com
    His Whatssap: +2348103601042
      

    ReplyDelete
  41. Hello everyone i am happy to say that i was cure from HIV/AIDS by Dr Padman with his herbal medications after i tested positive july 2016 and ever since then i have been on medications to extend my living on earth. One faithful day i was searching on line if i could get some tips on how to cure my illness and i saw a comment on how Dr Padman cure HIV with herbs,i was surprise and i contact him on the email they provided on the comment and i explain my problem to him and he also prepare the herbs and send to me which i use for one week as i was instructed by him and after 2weeks i went to hospital for checkup and i tested Negative and i am fully cured from the disease and i am so greatful to Dr Padman.You can also reach Dr Padman on his padmanlovespell@yahoo.com , https://twitter.com/padman_dr. https://padmanspell.com WhatsApp +19492293867

    ReplyDelete
  42. I want to share a testimony of how Dr OSAGIE 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 had so many relationship called off because of my situation,m i have used so many product which i found online but none could offer me the help i searched for Which was very painful and then i saw some few testimonies about this herbal specialist called Dr OSAGIE and decided to email him on so I gave his herbal product a try. i emailed him and he got back to me and we discussed, he gave me some comforting words and encouraged me also ans then gave me his herbal pills and 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 9.7 inches longer and am so happy contact Dr OSAGIE via drosagiesolutionhome5 @ gmail. com Via whatapp +2348034778129.

    ReplyDelete
  43. WITH THE HELP OF  DR PERFECT ENLARGEMENT CREAM MY PENIS GROW  FROM 3 INCHES TO 9 INCHES YOU CAN ON EMAIL AT SOLUTIONTOALLPROBLEMS1@GMAIL.COM

    Hello everyone I have to give my testimony about a herbal doctor called Dr Perfect. I was heartbroken because I had a very small penis not good enough to satisfy a woman, I have been in so many relationships but they were cut off because of my situation, I have used so many products prescribed by the doctor but none could render me the help I was looking for, so I decided to search online for solution and I saw a lot of comments about this specialist called Dr Perfect on how he helped people with small penis, cancer and others so I decided to give his herbal product a try, I messaged him on WhatsApp and replied me back, he gave me some comforting words we talked on how i can receive the product and he sent me his herbal product for penis enlargement, within 1 week of using it I began to feel the enlargement of my penis, now it just two weeks of me using his products my penis is about 9 inches longer, and I settle things with my girlfriend I was surprised when she said that she is satisfied with my performance in bed and am happy that i have a big penis now all thanks to Dr Perfect feel free to contact Dr Perfect at solutiontoallproblems1@gmail.com or WhatsApp him +1(256)251-3614 and get your enlargement cream     

    ReplyDelete
  44. Is there any way that you feel like the situation about student registration can be rectified? assignment expert

    ReplyDelete
  45. Wow is good to be back with my ex again, thank you Dr Ekpen for the help, I just want to let you know that is reading this post in case you are having issues with your lover and is leading to divorce and you don’t want the divorce, Dr Ekpen is the answer to your problem. Or you are already divorce and you still want him/her contact Dr Ekpen the spell caster now on (ekpentemple@gmail.com) and you will be glad you did

    ReplyDelete
  46. Am here to appreciate Dr Aliaro for using his herbal medicine to cure my Herpes virus. since 3 years now I have been living with this virus and it has been giving me challenges, I was so perplexed cause i have been taking several drugs to be cured but all of my effort was in vain,one .morning i was browsing through the internet then i saw several testimonies about Dr. Aliaro curing people from Herpes virus and immediately i contacted Dr. Aliaro on his email: draliarohomeofgrace@gmail.com, i told him about my troubles and he told me that i must be cured, gave me some instructions and which i rightly followed. so he prepared a herbal medicine for me and sent it to me which i used for 2 weeks and everything was like a dream to me and my Herpes virus was totally gone, why don’t you contact him today and be free from your diseases because he is very good and honest Doctor. contact him via email; draliarohomeofgrace@gmail.com or Whats App him: +2347038729039.

    ReplyDelete
  47. I recommend doctor razor herbal medicine to anyone battling with Herpes Infection...I am so happy to be finally cured of herpes simplex virus  by herbalist Razor,Ever since i was diagnosed with the virus i have been using medical drugs to suppress it, i later realized it was causing more damage to my health than the virus,i opted for herbs and got to find out about the great work herbalist Doctor razor have been doing with his herbal remedy. i contacted him and he promised to help me get rid of it,after 4 days i received a package fro the delivery service and it was from the doctor who sent me the herbal treatment in Dallas,Texas USA, And he instructed me on how i was going too take in for the 18 days. After completing the dosage he told e to go for a medical checkup and when i did the doctors conducted some test on me but they were stunned that my status was now negative,they conducted several test on me to be sure. i even went to Medical City Dallas Hospital, where they conducted another test and it was still negative. I am so grateful to you herbal doctor razor , God will continue to prosper you,i pray the world gets to know about you and your herbal exploits. Reach him on his email : drrazorherbalhome@gmail.com Whatsapp/Call his cell phone on +2349065420442. PLEASE SHARE , SO THE WORLD CAN GET TO KNOW ABOUT HIM

    ReplyDelete
  48. I have been suffering from (HERPES) disease for the last four years and had constant pain, especially in my knees. During the first year, I had faith in God that I would be healed someday.This disease started to circulate all over my body and I have been taking treatment from my doctor, a few weeks ago I came on search on the internet if I could get any information concerning the prevention of this disease, on my search I saw a testimony of someone who has been healed from (Hepatitis B and Cancer) by this Man Dr. Nogadu and she also gave the email address of this man and advise we should contact him for any sickness that he would be of help, so I wrote to Dr. Nogadu telling him about my (HERPES Virus) he told me not to worry that I was going to be cured!! i never believed it, well after all the procedures and remedy given to me by this man few weeks later I started experiencing changes all over me as the Dr. assured me that I have cured, after some time i went to my doctor to confirmed if I have been finally healed behold it was TRUE, So friends my advice is if you have such sickness or any other at all you can email Dr.Nogadu (drnogaduherbalist@gmail.com) sir I am indeed grateful for the help I will forever recommend you to my friends!!! with your lovely Email Address ( drnogaduherbalist@gmail.com, whatsapp him on +2347010627760  

    ReplyDelete
  49. I can never appreciate Tokubo enough for helping me because I never thought that i will ever have a normal life again thinking I'll never get out of this hiv virus in my whole life but i was wrong. My story goes thus: I found dr tokubo contact in a post i followed online, I copied the email and contacted him because i read about how he cure a man of hiv and that he have herbal remedy for cancer, yeast infection,HIV, Herpes e.t.c. I told him all he needed to know about my hiv status and he told me to relax and stay calm that he will help me by sending his medicine to me via courier delivery and he did as he promised. I received my healing within 10 days of using his herbal remedy. my lost joy came back alive as there is no more HIV, no symptoms, no fear of transmitting the virus to my love ones. Now I'm in a relationship and my sex life is awesome. All these happened last month ago and I decided to keep silent because I wanted to be sure of the healing. Now I'm saying this because I have undergone series of medical check up and all results came out negative. At first i thought it was just a joke until i tried it out and it worked perfectly well. The doctor never asked me to talk about him but I see it as my little way of showing other people out there need his herbal medicine to be cured.  You can reach dr tokubo via his email at: drtokubotemple@gmail.com or you can whatsapp him on: +2349037990322

    ReplyDelete
  50. I want to thank Dr Emu a very powerful spell caster who help me to bring my husband back to me, few month ago i have a serious problem with my husband, to the extend that he left the house, and he started dating another woman and he stayed with the woman, i tried all i can to bring him back, but all my effort was useless until the day my friend came to my house and i told her every thing that had happened between me and my husband, then she told me of a powerful spell caster who help her when she was in the same problem I then contact Dr Emu and told him every thing and he told me not to worry my self again that my husband will come back to me after he has cast a spell on him, i thought it was a joke, after he had finish casting the spell, he told me that he had just finish casting the spell, to my greatest surprise within 48 hours, my husband really came back begging me to forgive him, if you need his help you can contact him with via email: Emutemple@gmail.com or add him up on his whatsapp +2347012841542 is willing to help any body that need his help.

    ReplyDelete

  51. I am here to give my testimony about Dr Ebhota who helped me.. i want to inform the public how i was cured from (HERPES SIMPLEX VIRUS) by salami, i visited different hospital but they gave me list of drugs like Famvir, Zovirax, and Valtrex which is very expensive to treat the symptoms and never cured me. I was browsing through the Internet searching for remedy on HERPES and i saw comment of people talking about how Dr Ehbota cured them. when i contacted him he gave me hope and send a Herbal medicine to me that i took for just 2 weeks and it seriously worked for me, my HERPES result came out negative. I am so happy as i am sharing this testimony. My advice to you all who thinks that there is no cure for herpes that is Not true just contact him and get cure from Dr Ebhota healing herbal cure of all kinds of sickness you may have like
    (1) CANCER,
    (2) DIABETES,
    (3) HIV&AIDS,
    (4) URINARY TRACT INFECTION,
    (5) CANCER,
    (6) IMPOTENCE,
    (7) BARENESS/INFERTILITY
    (8) DIARRHEA
    (9) ASTHMA
    (10)SIMPLEX HERPES AND GENITAL
    (11)COLD SORE
    HERPES. he also cure my friend from cervical cancer Email: drebhotasoultion@gmail.com or whatsapp him on +2348089535482

    ReplyDelete
  52. True life story that happened May 12th 2018..... I never believed in herbal cure,and i have spend lot of money and time in trying to get drugs from the hospital/clinic to get cured of my Herpes virus which i suffered from for 3 years and i was tired of ( acyclovir and valacyclovir ) drugs, herpes is a serious and recurring disease which can't be cured through drugs or injections by the American doctors but the best way to deal with herpes is by taking natural herbs medicine for it and is only few American doctors that know about this herbal medicine .. I have read about Dr Kham the great herbalist doctor from African who can cure disease with his powerful herbal medicine made with different combinations of natural roots, leaves and steams. for the people suffering from the following diseases, Herpes, Cancer, Als, Hepatitis, Diabetes, HPV, Infertility Infections ETC should contact him for his herbal medicine because i am a living testimony and i was cured of herpes. Although, I sent him what he requested and he sent me his herbal medicine which I took for 2 weeks and today when I went for a test I was tested for herpes negative. you can reach him through his email dr.khamcaregiver@gmail.com or whatsapp number:+2348159922297  or  you can get in touch with him on his website: drkhamherbalhealingcenter.wordpress.com/  he will help you out 

    ReplyDelete
  53. I’m Katty morgan from the States.I want to use this medium to appreciate Mrs Julia for coming on the platform to share her experience with Dr osuma i have been online looking for a genuine remedy to my illness of 5 years HIV until i read Mrs Julia post.As we all know these days the truth is rear so i didn’t want to believe Mrs Julia until a second taught asked me to.I contacted Dr osuma as directed by Mrs Julia and follow the procedures and everything worked out in a brief.I thought there was no actual cure for HIV until a little trial convinced me.i was cured after 3 weeks of usage of Dr osuma great herbal medicine,he has a cure for what so ever health challenging issue HIV,TB,VERTEBRAL ISSUE,CANCER,DIABETES,ISCHEMIC DISEASES,STROKE,RESPIRATORY INFECTIONS,PULMONARY DISEASE,ALZHEIMER”S DISEASE,DEHYDRATION,CIRRHOSIS ETC.You can contact him via his Email (drosumaherbalcure@gmail.com)or his whats-app number +2349054914348

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  54. I have been suffering from Herpes for the past 3 years and 8 months, and ever since then i have been taking series of treatment but there was no improvement until i came across testimonies of Dr Ogedegbe on how he has been curing different people from different diseases all over the world, then i contacted him as well. After our conversation he sent me the medicine which i took according to his instructions. When i was done taking the herbal medicine i went for a medical checkup and to my greatest surprise i was cured from Herpes. My heart is so filled with joy. If you are suffering from Herpes or any other disease you can contact Dr Ogedegbe today on this Email address: dr.ogedegbe6@gmail.com or WhatsApp him on this Number +2348109374702  .... he also has the cure for the following..............
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  55. Hi it's laa! 9 months ago my doctor told me I was diagnosed with HSV2. I was heart broken, However that same month i found a Dr. who helped me to cured the virus with natural herbal treatment permanently. thanks to Dr. omohan for his natural herbal treatment that eliminated this virus out in my body forever. his contact information for any incurable virus via; dromohanherbalmedicine@gmail.com or whatsapp him or call him through his phone number +2348164816038.    

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  58. Does anyone still doubt natural herbs? I've seen the great importance of natural supplements and the wonderful work they have done in people's lives. I wonder why people still spend their money on surgery, injections and drugs each time they are sick. Natural herbs can cure all kinds of illness.  My Herpes virus was totally reversed with natural herbs this year. Earlier this year my sister who lives in New Delhi India Purchased HSV herbal remedy from Dr Omola and he told her that his HSV herbal remedy only takes five weeks to reverse HSV completely, which she didn’t’ believe, but she had no choice than to purchase, because she knew COLD SORES was killing me slowly. When I received the herbal remedy, I only used it for five weeks, it was so shocking to see the outcome, all my cold sore disappeared and my HERPES VIRUS was fully reversed. I know it is hard to believe but am a living testimony, There is no harm in trying natural herbs supplements. Contact Dr Omola for his herbal remedy today... Email; dr.omolaherbalhome@gmail.com Call/Whatsapp +2348118116254 for more information  Thanks  

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  61. FINALLY FREE FROM HERPES VIRUS. what a miracle i never believe there is cure because my doctor tested me herpes positive and she told me there is no cure, i’m very happy today that i’m having a free life without this herpes virus, i can remember some months ago when i was crying all through the night and day that i can’t get cured from this herpes, i found this herbal man called Dr sunnyna on internet when i was doing research on cure for shingle i contacted him to found out if i can get help from this herpes virus, i was so surprise when he told me that he have the herbs cure to it and he sent me the herbal in less down 5 days i was so happy when i get someone giving me hope that he can cured me i took the herbal for just 2 weeks, when i went for test after taking the herbal i found out that i am cured i was so happy and surprise, i want to use this opportunity to inform you that there is cured to herpes virus you can also contact him for his help as soon as possible so that you can get rid of this herpes once and for all you can reach him through this email: drsunnyna@gmail.com or whatsApp him on +2348077875210 You can also contact him on any disease and virus in this he all have the herbal cure to it. 1 HIV/AIDS 2 HERPES 3 CANCER 4 ALS 5 HEPATITIS 6 DIABETES 7 LOVE SPELL 8 INFECTIONS 9 HIGN BLOOD PRESSURE,..... THANKS TO DR SUNNYNA FOE THE GOOD WORK IN LIFE YOU BLESS.....  

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  62. MY REVIEW ABOUT DOCTOR MOHAMMED HERPES CURE. Thank God I gave him a chance to cure me, I saw so many comments about him on the cure of herpes virus and other diseases and infection, this man is 100% real. well. i notice there are still other fake doctors on line which they have scam me before, thank God for coming across doctor mohammed facebook page which  www.facebook.com/Herpes-cure-with-herbal-medicine-643324002519440 i am perfectly cure from the virus and my result came out negative after taking doctor mohammed herbal medicine for weeks. you can also contact him on WHATSAPP/CHAT +2349036036397 EMAIL herbalcure12@gmail.comthis cure is real, i can not keep this healing to myself because i know a lot of people are dying silently of this virus thinking there is no cure. i have been scam severa time so i do not want you to fall victim of those fake doctor outside there that is why i refer you to the right doctor which is Doctor Mohammed

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  63. get your ex back with a love spell that works fast.
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  64. I want to use this opportunity to say a very big thanks to a great spell caster called Dr.Azaka brought back my happiness back again, by bringing back my ex lover back to me after many months of breakup and loneliness. With this i am convinced that you are sent to this word to rescue people from heartbreak and also the solution to every relationship problem. for those of you out there who have one relationship problem or the other why not contact Dr.Azaka on his email: Azakaspelltemple4@gmail.com

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  65. Greatest thanks to Dr Oyagu for his herbal drugs that he prepared for me and when i start using it in just 2weeks i was completely cured and that ended my HERPES SIMPLEX 1&2 DISEASE i am so happy and grateful to Dr Oyagu . after reading about him on a testimony of Jason Cash on a blogger. i knew suddenly Dr Oyagu was the right Doctor to cure my HERPES SIMPLEX 1&2 DISEASE. i discuss with Dr Oyagu and he prepared a herbal medicine for me and when it got sent to me in south korean . i used the herbal medicine and 2weeks and i went to check up again. after 15years of suffering from HERPES SIMPLEX 1&2 at last i am smiling once again. Dr Oyagu also has remedy to others disease like COLD SORES,HIV/AIDS,DIABETES.CANCER,HIGH BLOOD PRESSURE AND MANY MORE. I oblige everyone to contact this powerful herbalist Dr Oyagu and be free from your suffering. contact his WhatsApp line: +2348101755322 or his Email:Oyaguherbalhome@gmail.com

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  66. All thanks to Dr Okougbo for his marvelous work in my life, I was diagnosed of Herpes since 2015 and I was taking my medications, I wasn't satisfied and I needed to get the Herpes out of my blood, I searched about some possible cure for Herpes and I saw a comment about Dr Okougbo, how he cured Herpes with his herbal medicine, I contacted him and he guided me. I asked for solutions, he started the remedy for my health, he sent me the medicine through UPS SPEED POST. I took the medicine as prescribed by him and 14 days later I was cured from Herpes. Dr , truly you are great. Do you need his help also? Why don't you contact him through this Email:dr.okougboherbalhome@gmail.com Dr Okougbo CAN AS WELL CURE THE FOLLOWING DISEASES:-1. HIV/AIDS2. HSV 3 LUPUS4. ALS5. HEPATITIS B6. DIABETES7. HUMAN PAPILOMA VIRUS DISEASE(HPV)8. ALZHEIMER WhatsApp him on +2347062217261

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  67. MY TESTIMONY OF HOW I GOT CURED FROM GENITAL HERPES VIRUS

    It's a pleasure for me to write this testimony about how I got my Genital Herpes cured a month ago. I have been reading so many comments of some people who were cured from various diseases by Dr .Hazim, but I never believed them. I was hurt and depressed so I was too curious and wanted to try Dr. Hazim , then I contacted him through his email. When I contacted him, he assured me 100% that he will heal me, I pleaded with him to help me out. My treatment was a great success, he healed me just as he promised. He sent me his medication and asked me to go for check up after 21 days of taking the medication. I agreed with him. I took this medication and went for a check up after 21 days of the treatment, To my greatest surprise my result came out  negative after the treatment, I'm very happy that I was cured and healthy again. I waited for 3 weeks to be very sure if I was completely healed before writing this testimony. I did another blood test one week ago and it was still Herpes negative. so i guess it's time i recommend anyone going through Herpes, HSV-1 or HSV-2, HIV, HPV, Hepatitis B, Diabetes, Cancer, ALS  to contact this great man through his Email (usmandrhazim@gmail.com) OR add him up on whatsApp  +2349058026857
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  69. First, I want to complement this page administrator for creating this platform for us to express our feelings. Herpes is a serious and recurring disease which can't be cured through drugs or injections by the American doctors but the best way to deal with herpes is by taking natural herbs medicine from DR. ISHIAKU the greatest herbalist doctor in the world and is only few American doctors that know about this herbal medicine from Dr ISHIAKU .. I have read about Dr ISHIAKU the great herbalist doctor from African who can cure disease with his powerful herbal medicine. for the people suffering from the following diseases, Herpes,HIV/Aids, Cancer, Also, Hepatitis, Diabetes, Hpv, Infections ETC should contact him for his herbal medicine because i am a living testimony and i was cured of herpes. Although, i sent him what he requested and he sent me his medicine through DHL courier delivery company which i took for some days and today when i went for test, i was tested herpes negative. you can reach him through his  WhatsApp him at +2348180828544

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  70. A g Thanks to you doctor   Just confirm am completely cure free from hsv with the help of his wonderful herbs medicine, may God continue to bless you and your wonderful herbs medicine thanks so much Dr Abubaka anyone looking for any herbs medicine should kindly contact Dr Abubaka  to place your order for his lovely herbs medicine Via email: DrAbubaka@gmail.com or WhatsApp: +2348075551672

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  71. A g Thanks to you doctor   Just confirm am completely cure free from hsv with the help of his wonderful herbs medicine, may God continue to bless you and your wonderful herbs medicine thanks so much Dr Abubaka anyone looking for any herbs medicine should kindly contact Dr Abubaka  to place your order for his lovely herbs medicine Via email: DrAbubaka@gmail.com or WhatsApp: +2348075551672

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  72. I Want To Appreciate Dr. momoh for his great deeds, I Was Diagnosed With Herpes Virus Last 2018, And i Was Looking For Solution To Be Cured Luckily I Saw Testimonies On How Dr. momoh Cure Herpes Virus I Decided To Contact Dr. momoh I Contacted Him He Prepared A Herbal Medicine Portion And Sent It To Me,I Started The Herbal Medicine For My Health.He Gave Me Step By Step Instructions On How To Apply It, When I Applied It As Instructed, I Was Cured Of This Deadly Herpes Within 2 weeks, I Am Now Herpes Negative.My Brother And Sister I Know That There Are So Many People That Have The Same Herpes Virus Please contact Dr momoh To Help You Too, And Help Me To Thank Dr. momoh For Curing Me, I’m Cured By Dr. momoh Herbal Medicine, His Contact Email:(dr.momoh9@gmail.com) Or Cell Whatsapp Number  +234 708 372 4098   thank you so much DR.momoh. He can also cure other diseases/infections

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  73. I’m indeed very happy for the great help that Dr Osebor rendered to me,I was diagnosed with HSV 2 on July 7, 2017 and I have tried all possible means to get cure but all to no avail, until i saw a post in a health forum concerning herbal doctor Dr Osebor, who prepares herbal medicine to cure all kind of diseases/Infection including Herpes Simplex virus Type 2, at first i doubted if it was real but decided to give it a try, when i contact this herbal doctor via his email,oseborwinbacktemple@gmail.com He assured me of a cure, he prepared a herbal medicine and sent it to me via courier service, when i received this herbal medicine, he gave me instructions on how to use it, when i applied it as instructed, i was cured of this deadly virus within 18 days of usage,he told me to go for a medical check up and i went for test, I couldn't believe i was negative and the HERPES VIRUS in my body got cured, I and my family are so happy and grateful to God for using Dr Osebor to Liberate me. Reach Out to this great herbal doctor via his email : oseborwinbacktemple@gmail.com you can also reach him on WhatsApp +2348073245515

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  74. I am very happy today to share this amazing testimony on how Dr. AFRID the herbal doctor was able to cure me from my Herpes Virus with his herbal medicine. I have been a herpes patient for almost 8 months now and have tried different methods of treatment to ensure that I am cured of this terrible disease, but none worked for me, so I had to leave everything to God to handle as I was a Christian who had faith that one day God would intervene in my life, yet I felt so sad and desperate as I was losing almost everaything due to my illness, A few months ago while I was surfing the internet I saw different recommendation about Dr AFRID on how he have been using his herbal Medicine to treat and cure people, these people advice we contact Dr. AFRID for any problem that would help immediately, I contacted Dr AFRID and I told him how I got his contact and also about my disease, after some time Dr. AFRID told me to have faith that he would prepare for me a medication of herbal herbs, he told me I would take this medicine for a few weeks and also asked my home for home address so as possible for him to submit the drug for me, so my good friends after all the process and everything Dr AFRID actually sent me the medicine, I took it as I was directed by Dr. AFRID, after a few weeks passed, while on Dr. AFRID medication I began to experience changes in my body, I had to call my doctor at the hospital for some blood test, after test my hospital doctor told me that I was no longer with the herpes virus and my blood is pretty good, I can not even believe this, Friends well today i am Herpes Free and i want everyone to know that there is a cure for herpes for those who will contact Dr AFRID after reading my testimony, you can kindly contact Dr. AFRID in (DRAFRIDHERBALHOME@GMAIL.C OM) or whatsApp him +2349057260738, God bless you all  

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  75. I am very happy today to share this amazing testimony on how Dr. AFRID the herbal doctor was able to cure me from my Herpes Virus with his herbal medicine. I have been a herpes patient for almost 8 months now and have tried different methods of treatment to ensure that I am cured of this terrible disease, but none worked for me, so I had to leave everything to God to handle as I was a Christian who had faith that one day God would intervene in my life, yet I felt so sad and desperate as I was losing almost everaything due to my illness, A few months ago while I was surfing the internet I saw different recommendation about Dr AFRID on how he have been using his herbal Medicine to treat and cure people, these people advice we contact Dr. AFRID for any problem that would help immediately, I contacted Dr AFRID and I told him how I got his contact and also about my disease, after some time Dr. AFRID told me to have faith that he would prepare for me a medication of herbal herbs, he told me I would take this medicine for a few weeks and also asked my home for home address so as possible for him to submit the drug for me, so my good friends after all the process and everything Dr AFRID actually sent me the medicine, I took it as I was directed by Dr. AFRID, after a few weeks passed, while on Dr. AFRID medication I began to experience changes in my body, I had to call my doctor at the hospital for some blood test, after test my hospital doctor told me that I was no longer with the herpes virus and my blood is pretty good, I can not even believe this, Friends well today i am Herpes Free and i want everyone to know that there is a cure for herpes for those who will contact Dr AFRID after reading my testimony, you can kindly contact Dr. AFRID in (DRAFRIDHERBALHOME@GMAIL.C OM) or whatsApp him +2349057260738, God bless you all  

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  76. Hello! I'm very excited to inform everyone that I'm completely cured from my HSV 1&2 recently. I have used Oregano oil, Coconut oil, Acyclovir, Valacyclovir, Famciclovir, and some other products and it's really help during my outbreaks but I totally got cured! from my HSV with a strong and active herbal medicine ordered from a powerful herbalist and it completely fought the virus from my nervous system and I was tested negative after 14 days of using the herbal medicine. I'm here to let you all know that herpes virus has a complete cure, I got rid of mine with the help of Dr Okiti and his herbal exploit. Contact him via email: drokitiherbalhome100@gmail.com or WhatsApp +234 704 324 0787

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  77. Hello! I'm very excited to inform everyone that I'm completely cured from my HSV 1&2 recently. I have used Oregano oil, Coconut oil, Acyclovir, Valacyclovir, Famciclovir, and some other products and it's really help during my outbreaks but I totally got cured! from my HSV with a strong and active herbal medicine ordered from a powerful herbalist and it completely fought the virus from my nervous system and I was tested negative after 14 days of using the herbal medicine. I'm here to let you all know that herpes virus has a complete cure, I got rid of mine with the help of Dr Okiti and his herbal exploit. Contact him via email: drokitiherbalhome100@gmail.com or WhatsApp +234 704 324 0787

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  78. Omg I Finally Got Helped  !! I'm so excited right now, I just have to share my testimony on this Forum.. The feeling of being loved takes away so much burden from our shoulders. I had all this but I made a big mistake when I cheated on my wife with another woman  and my wife left me for over 4 months after she found out..  I was lonely, sad and devastated. Luckily I was directed to a very powerful spell caster Dr Emu who helped me cast a spell of reconciliation on our Relationship and he brought back my wife and now she loves me far more than ever.. I'm so happy with life now. Thank you so much Dr Emu, kindly Contact  Dr Emu Today and get any kind of help you want.. Via Email emutemple@gmail.com or Call/WhatsApp +2347012841542

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  87. Greatest thanks to Dr Eromosele for his herbal drugs that he prepared for me and when i start using it in just 2weeks i was completely cured and that ended my HERPES SIMPLEX 1&2 DISEASE i am so happy and grateful to Dr Eromosele . after reading about him on a testimony of Jason Cash on a blogger. I knew suddenly Dr Eromosele was the right Doctor to cure my HERPES SIMPLEX 1&2 DISEASE. I discuss with Dr Eromosele and he prepared a herbal medicine for me and when it got sent to me in South Korean. I used the herbal medicine and 2weeks and i went to check up again. after 15years of suffering from HERPES SIMPLEX 1&2 at last i am smiling once again. Dr Eromosele also has remedy to others disease like COLD SORES, HIV/AIDS, DIABETES, CANCER, HIGH BLOOD PRESSURE AND MANY MORE. I oblige everyone to contact this powerful herbalist Dr Eromosele and be free from your suffering. contact his WhatsApp line: +2348075799423 or his Email:dreromosele156@gmail.com

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  91. few week ago I felt some pains and I went to the hospital my doc told me I had hpv about 1 yr and I need to start the treatment early, he gave me some medicine to be taking and I told him no I’ll not, because I hated taking medicine when I won’t not see cure for the purpose. After I got home I started getting worried searching for strong advice and I found valid natural treatment online lot people says they got hpv cure from Dr onokun and I email Dr Onokun 3 days passed, I purchase his cure online some weeks after the process taking his treatment i got cured. I went for checkup twice after taking the natural treatment from the herbalist called Dr onokun and i tested negative. contact him on email: Dronokunherbalcure@gmail.com or website via www.Dronokunherbalcure.wordpress.com

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