PENS Therapy - any success stories please?

No, we haven't had allergy tests and strangely haven't even been offered them. Am going to push to have them done after he has finished the steroid trial he is currently on (which I don't think is making such a difference as last time) I think my Vet can do them so won't have to go anywhere either which is good. I think they inject certain allergens into the body and then take blood samples to see if there's a reaction but not sure myself! Also they do skin scrapes I think too. Will be worth knowing though so that's the next thing we are going to do.
 
Mine isn't ridiculously itchy/twitchy either!

A friend had a horse allergy tested after it came out in hives on and off for 3 months - turned out she was allergic to the conifers that next door had planted!
Fingers crossed something shows up for you and you can get him comfortable again..
 
Cascada, how's your boy getting on? Any improvement?
Mine goes for a CT scan on Tues - not optimistic about them finding anything of any help!! Definitely not looking forward to travelling a big silly warmblood who I can't work any energy off...
 
Oh good luck for Tuesday!! I guess even if they don't find anything it will be another thing ruled out. Have you got far to travel him?? Have you noticed any change since he's been off the drug trial?
Mines been okay - the headshaking was much improved for the first 5 days after the second treatment, although it was still there when I tried to do anything with him in the day.
We were meant to have the Third treatment last Friday but as there had been a slight improvement they said to push it back to next Friday.
It's defiantly slightly better than it was when it was really bad, he has better days and worse days. Seems to be worse in the day and better morning and evening, which is frustrating as I'm not there in the day to monitor him. He's been in a restricted grazing field at night and out in the main heard field in the day so hoping he might lose a bit of weight. That means he's more interested in eating during the day which distracts a bit from the headshaking. The weathers been so horrible here today, so much rain: I noticed when I brought him in this evening that he was walking with his head turned out of the rain - I think the rain was hurting him as he had his worse side turned away from it, even though he wasn't actually head shaking! Left him in the stable overnight for the first time tonight since the headshaking came back so hopefully he's not just stood there overnight doing it. Will let you know how he gets on after the 3rd treatment. It's still very much there but I have noticed an improvement, and just trying to manage it by leaving him be in the day so he can eat and bringing him in to brush etc in the evening when it's not as bad! Fingers crossed that the 3rd one brings more positive results!
 
Glad to hear you've seen some improvement! Hopefully the next treatment will help even more!
Mine is better first thing in a morning. I was able to do a bit with him last week (a lunge and two short hacks!), although he was stopping to rub his face a lot and was really, really bad one day, for no reason that I could think of! He has also been worse in the field which is strange given that he was vaguely workable! He also twitched while eating his tea yesterday which is a first when he's in his stable...
The vets is an hour away - he's not the best traveller as he loses his patience so fingers crossed we make it in one piece!!
Will let you know how we get on! They have a particular interest in head shaking cases so I'll try to get as much info out of them as poss & pass it on!!
 
Just found this thread and thought I'd add with a success story. My horse was part of the initial study trial with Veronica Roberts down at Langford Equine. He has been shake free for 3 and half years now, although is still incredibly sensitive to any stimuli (flies in particular) around his nose. Prior to the study he was horrific and the PENs was a last ditch attempt, but it was honestly the best ting I ever did! I really hope your horse responds to the treatment and if you want any information, etc on him / how he behaved etc, feel free to ask and I'll help as much as I can. On the back of this, I've also set up a Facebook group called Head Shaking UK as I found that there wasn't that much helpful information out there.
 
Just found this thread and thought I'd add with a success story. My horse was part of the initial study trial with Veronica Roberts down at Langford Equine. He has been shake free for 3 and half years now, although is still incredibly sensitive to any stimuli (flies in particular) around his nose. Prior to the study he was horrific and the PENs was a last ditch attempt, but it was honestly the best ting I ever did! I really hope your horse responds to the treatment and if you want any information, etc on him / how he behaved etc, feel free to ask and I'll help as much as I can. On the back of this, I've also set up a Facebook group called Head Shaking UK as I found that there wasn't that much helpful information out there.

Oh thats so good to hear - really pleased that you have one of the (seemingly rare) success stories :)

We were originally referred to veronica last year when my boy first started the shaking, but then he stopped as quickly as it started after about 3 months and it only returned in October - but 100 times worse and has been consistent now. Have now been referred to Liphook where he has had the first and second treatment so far!

Can i ask how your horse responded after each of the 3 treatments? So far mine was so so much worse after the first, and then responded much better to the second one - we are now going for the 3rd after pushing it back by a week. Headshaking still there but it does seem slightly better than how it was. Still unrideable and spends most of the time out in the field grazing - more my fear of making it any worse by trying to do anything with him!!
Would be very interested to hear a bit more about how yours responded after the treatments. Has he had any sort of headshaking since? Was he diagnosed as having any triggers to the headshaking or was he just a constant head shaker?

(sorry for all the questions - i will look for the group on facebook too!)
 
I know I've been really lucky with him. Dude actually ended up having 5 treatments in total. He started in the December and had the first two (we're in Durham so he was in livery down at Bristol for two weeks) and over the Christmas he had improved loads. Just before he was going back down for his last treatment he fractured his leg in the field, so obviously couldn't travel back. He re-started the trial again at the end of May and had his first two treatments again, and again he came back and the difference was amazing! I just treated him as normal and went back to schooling and hacking but obviously keeping an eye on him. He lasted almost two months before having to have his third and final treatment, which again went really well.
I have him on a head shaking supplement from Hack-up which is probably more of a placebo than anything but I daren't take him off it! He's also ridden and turned out in a full fly mask while there's any trace of flies. I've been riding still in his fly mask up to December this year. Without it he reverts back to uncontrollable head shaking and is virtually unrideable again. It's really strange but after the treatments he's become very sensitive around his nose.

Regarding when he first started head shaking, there were no triggers at all (I suspected possibly rape seed made it a lot worse but couldn't prove it). He had the CT scans, etc and was diagnosed an ideopathic head shaker. He literally started overnight, there were no triggers etc, which I think made it so much harder to accept.

I really hope your boy responds and if I can help at all feel free to post in the group / ask me
 
Oh that's really interesting! - I actually just went in and read your story on the page! Gosh - that must have been hard when he fractured his leg poor boy, having to deal with that and headshaking. That seems like he reacted really well to it - im slightly concerned with my boy as he had such a negative response to the first treatment and the second one, although its slightly improved, its not gone by any means.

Very interesting about the flies as well - ive not tried mine in a fly mask in the field. Last year the headshaking disappeared when the summer months came in, around June, but not sure what this summer holds as its meant to be something that only gets worse over time, rather than better. I might try putting a fly mask on him and see if that makes a difference.
Its such a horrible condition :( and all the case studies i seem to read on it have completely different results/triggers etc so its so hard to know what will happen. Your post has given me some hope though with this treatment, fingers crossed!
 
Yeah he's been very unlucky but on the same hand also very lucky! Now you would never know he's had any problems at all, he back out competing and behaving like the stallion he used to be!

I'll keep everything crossed for your boy - I'm trying to find the article from Your Horse that Dude was in to publish on the page, which might offer some help too. My boyfriend accidentally recycled the original copy ....!
 
Update on my boy: a pattern has pretty much been established with his head shaking. He is always worse in the morning having been in the stable overnight. He wears the nosenet 24/7 except in the field when he is virtually symptom free with only the occasional head shake or sneeze.

Sometimes he is fine until I take his rug off and then he goes very twitchy on his body and starts head shaking and sneezing. Vet came out last week and wasn't overly helpful. Doesn't seem to have a solution other than turn him out which I think his just avoiding the problem IMO. He is reasonably comfortable in stable in nose net so I see no problem in continuing with same routine in case he gets much worse then I will reconsider.

Still pushing for allergy tests which she doesn't seem keen on doing but I want to rule it out. Especially as he had some small lumps on top of his back leg the other morning like a rash of some sort! Had chiropractor out today and his TMJ joint was out of alignment and that has now been sorted so will see how he is tomorrow. Doubt it will have been just that but that would have been adding to his discomfort for sure. Chiropractor agrees with me it sounds like allergy related condition.

In all honesty the vets do not seem too bothered now insurance money has nearly ran out and we have declined the PENS even if they decide to offer it as it's just too invasive IMO and with him reacting negatively to the nerve blocks it isn't suspected to be Trigeminal Nerualgia as much as before.
 
Oh yes that does sound like it could be allergy related - I wonder why the vets aren't too keen on allergy testing. It seems like it's a good thing to test for, given his symptoms! Or at least another thing to rule out.
Mine also can start headshaking when I change rugs, although more when I put his rugs on - this evening he was fine and as it was raining I thought I would bring him in for the night - no head shaking until I changed his rug, then that was it the headshaking started and had to put him back out as he's much better when he's out as he can graze to distract himself.
I think if you can manage it with the nose nets etc if he's comfortable then least he can continue in his routine, that's what I've been trying to do -trying to avoid making it worse! Hopefully you can get your allergy tests done and it might show up something. Fingers crossed!
 
So we went for the CT today - luckily he travelled well and arrived calmly. After discussion with the vet about his symptoms etc we lunged him and his head shaking was very obvious but not as bad as it can be.
They looked at him for 3 hours in total and nerve blocked his face higher up than had been done before......he was then lunged again and was absolutely horrendous it was very hard to watch as he was clearly in distress even when stood still...
They the CT scanned him which didn't throw up anything of any significance (which was as expected).
Having started out speaking to me about PENS therapy as something to consider, the vet ended the day saying that given his reaction to the nerve block he didn't think it would be successful for him and also given that he's 6yrs old, the lasting effectiveness would be negligible...
He said that the best thing for him would be to have him put down....
It isn't a shock to hear this, I knew in reality that that was the way we were heading, however he asked if I would be taking him home or if I wanted to leave him for them to put down which really brought it home....
He's currently home in his familiar stable where he'll be loved, spoilt and I'll have him pts where he's happy...
I'm heartbroken, I have absolutely no idea what I'm going to do without him :(

Spotty-pony, I hope you manage to get your vets to allergy test your boy, it does sound as if there is something that sets him off inside.
 
Oh I'm so sorry to hear this :( that's absolutely devastating! Even though as you've said its not something that you were completely surprised to hear, having it actually said out loud must just be horrendous.
Not sure if its of any use - but seeing as they both seem to react in similar ways/no triggers etc - mine never actually had a nerve block before going ahead with the PENS. When they saw the head shaking the decided to offer the PENS treatment and said there wasn't much point in doing the nerve block as they were confident that it was the nerve. I dont know much about the nerve block, but i wonder what surface area it actually covers as its quite a long nerve - if the block didn't quite cover the area thats causing the problem, could it actually make the symptoms worse? I dont know :s
Have you thought about contacting Veronica Roberts at Bristol who pioneered the PENS treatment and is one of the leading Headshaking researchers as a last resort - maybe get her view on whether she thinks it would be worth a shot? I guess they dont know enough really about the long term effectiveness of the treatment as its so new.
This truly is one of the most heartbreaking conditions that could happen to these poor horses, I literally cant even imagine how this must feel being told that - although inevitably it sounds like the majority of us in this situation face the same decision, except for a few lucky ones that manage to respond well enough to manage the condition.
So sorry to hear this - I really feel for you :( Is there any way you think that he could be retired to field as a companion - or is the headshaking too bad even in the field to be managed?
 
Oh I'm so sorry to hear this :( that's absolutely devastating! Even though as you've said its not something that you were completely surprised to hear, having it actually said out loud must just be horrendous.
Not sure if its of any use - but seeing as they both seem to react in similar ways/no triggers etc - mine never actually had a nerve block before going ahead with the PENS. When they saw the head shaking the decided to offer the PENS treatment and said there wasn't much point in doing the nerve block as they were confident that it was the nerve. I dont know much about the nerve block, but i wonder what surface area it actually covers as its quite a long nerve - if the block didn't quite cover the area thats causing the problem, could it actually make the symptoms worse? I dont know :s
Have you thought about contacting Veronica Roberts at Bristol who pioneered the PENS treatment and is one of the leading Headshaking researchers as a last resort - maybe get her view on whether she thinks it would be worth a shot? I guess they dont know enough really about the long term effectiveness of the treatment as its so new.
This truly is one of the most heartbreaking conditions that could happen to these poor horses, I literally cant even imagine how this must feel being told that - although inevitably it sounds like the majority of us in this situation face the same decision, except for a few lucky ones that manage to respond well enough to manage the condition.
So sorry to hear this - I really feel for you :( Is there any way you think that he could be retired to field as a companion - or is the headshaking too bad even in the field to be managed?

Thanks, you're support means a lot as unless you've had a head shaker you can't possibly know how hard it is to see them in pain and how useless you feel when you're unable to help them.
My boy is quite a nervous horse and I feel he's been through enough in his short life so far, so putting him through the PENS therapy for not much improvement isn't something I want to do. If there was a bigger success rate it would be a different matter.
Unfortunately he's a 17hh 6yr old warmblood who has energy to burn and loves to wrestle his field friends. No one would want him as a companion as he's too boisterous and a poor doer, although he is a total gentleman to handle. If I had the money to buy him a bossy pony and keep them in my field then I would but I honestly don't think he'd be happy, especially if his symptoms carry on as they are now...
I just have to be brave and do what's right for him - it's not the first time I've had to do it, it probably won't be the last but it's certainly one of the hardest, I love the bones of him... :(
 
Oh yes that makes total sense, I see what your saying there, you wouldn't want him to be unhappy and not have a good quality of life if he wouldn't be happy retiring etc, wouldn't be fair. I know, watching them in pain and not being able to do anything is just the worse. So sad that he's developed it at such a young age! I think it comes down to the fact that you know your boy best and while it's probably one of the most heartbreaking and difficult decisions to make, you will know if it's the right and best thing for him :( least you can take some comfort that your doing right by him. So sorry today didn't go as hoped
 
This has been one of the most interesting and heartbreaking threads I have ever read on here. You poor things - what an horrible condition to try and help a horse through.

I have never had anything to do with a headshaker where it wasn't seasonal, but after reading this I really hope that more research may be done on it imminently.

Dazed'n'confused - I'm so sorry it doesn't look like a good outcome is possible for your boy.
 
This has been one of the most interesting and heartbreaking threads I have ever read on here. You poor things - what an horrible condition to try and help a horse through.

I have never had anything to do with a headshaker where it wasn't seasonal, but after reading this I really hope that more research may be done on it imminently.

Dazed'n'confused - I'm so sorry it doesn't look like a good outcome is possible for your boy.

Exactly this.

I had no idea headshaking could be as serious as this. Have been following this thread after the OP asked about craniosacral therapists on another thread (did you ever find a local one?) and it just sounds awful, for both horse and owner.

Really sorry to hear that nothing has helped your boy, DnConfused. I had a quick look and google about headshaking and read that the human version is dubbed 'the suicide disease' because of the high numbers of people with the disease who commit suicide.
 
Exactly this.

I had no idea headshaking could be as serious as this. Have been following this thread after the OP asked about craniosacral therapists on another thread (did you ever find a local one?) and it just sounds awful, for both horse and owner.

Really sorry to hear that nothing has helped your boy, DnConfused. I had a quick look and google about headshaking and read that the human version is dubbed 'the suicide disease' because of the high numbers of people with the disease who commit suicide.

DabDab & Teacups thank you, it truly is heartbreaking. I also had no real concept of how bad head shaking can be, I just thought it was something that happened in summer and that could be helped by nose nets or antihistamines. I can honestly say that it's the most soul destroying disease as you bust a gut to try and help them but nothing seems to work.

I never found a specialist Craniosacral therapist but I did have him looked at by 3 different bodywork type people. Nothing of any significance came to light and whilst he enjoyed his treatments, no improvement was seen.

I suffer from migraines and when I look in his eyes (even on "good" days) he has the same look that I do when I'm in a lot of pain. I read about the high suicide rate in humans too - I can see why....
I wish I could help him, we could have had so much fun together but I have tried all I can and I have to be satisfied that he's known love, kindness and empathy with me which I'm more than sure he hasn't had before...
 
I am so sorry Dazed n Confused to hear about your boy. Cant even begin to imagine how hard this must be.

If it's worth one last chance I DO know a qualified Equine Cranio-Sacral Therapist. Have a Google search for Jean Whitebread. I think her website is Equine Reconnect or something like that. She is very good, I haven't used her myself but know people who have with results and I also know her personally as I used to work with her.

Also, has your Vet checked for TMJ problems? I only ask because the more I read about this, the more I lose faith in the fact they actually know enough about this joint as apparently most don't really investigate in that area as they don't see any relevance to it.

My Chiropractor came to see my boy on Monday and his atlas bone was out - which hadn't been noted by the Vets. She put this right and he didn't head shake or sneeze for the following two days - even without the nosenet! I thought she had cured him until this Morning when he started again. :( But the fact he was so much better after the treatment is a big clue and I am going to investigate further about TMJ issues now as well as allergies.
 
I am so sorry Dazed n Confused to hear about your boy. Cant even begin to imagine how hard this must be.

If it's worth one last chance I DO know a qualified Equine Cranio-Sacral Therapist. Have a Google search for Jean Whitebread. I think her website is Equine Reconnect or something like that. She is very good, I haven't used her myself but know people who have with results and I also know her personally as I used to work with her.

Also, has your Vet checked for TMJ problems? I only ask because the more I read about this, the more I lose faith in the fact they actually know enough about this joint as apparently most don't really investigate in that area as they don't see any relevance to it.

My Chiropractor came to see my boy on Monday and his atlas bone was out - which hadn't been noted by the Vets. She put this right and he didn't head shake or sneeze for the following two days - even without the nosenet! I thought she had cured him until this Morning when he started again. :( But the fact he was so much better after the treatment is a big clue and I am going to investigate further about TMJ issues now as well as allergies.

Thank you, yes his TMJ was investigated as I too had seen the success that some had had when this was put right - I even asked the vet on Tues to double check.

I really hope you can get your boy right, it sounds hopeful if he was ok, even if it was just for a short time - maybe with more manipulation the time he's ok will start to get longer.
I'll keep my fingers crossed for both of you - we need a success story for at least one of us, preferably two!!
 
I have read this post with interest but not commented until now as I have no experience of head shaking. However I wanted to say how sorry I am to hear that this is the outcome and wish you all the best, it sounds like it's been a horrible time.
 
I have read this post with interest but not commented until now as I have no experience of head shaking. However I wanted to say how sorry I am to hear that this is the outcome and wish you all the best, it sounds like it's been a horrible time.

Thank you, it's been so hard watching him in obvious distress knowing that there's nothing I can do or give him to alleviate it. I just hope that one day they'll know enough about it to find a cure :(
 
Dazed n Confused - have you had your boy allergy tested just in case? Do you think it might be a last thing to consider?

I've discussed this with both vets but they both felt that it wasn't something worth persuing. Their rationale was that even if a glaringly obvious allergy showed up it would be hard to medicate given that he didn't respond to any antihistamine or steroid drug trials. There is also no pattern to his good and bad days (I've written everything down daily for months & months to try and establish a trend weather wise and different pollen wise but nothing stands out unfortunately) - he's been on two different yards with very different surroundings but he showed no improvement. :(
 
Hello all,

Just an quick update for the post on my boy.

We had our 3rd and final PENS treatment last Friday.

He headshook as usual for a few days after (which the vet said would be normal - sometimes after the 3rd treatment they can get worse for about a week before you see any positive changes) and now for the last 3 days i have seen no headshaking. Albeit as i have previously mentioned im there 6.30 am and then 6.30pm so cant comment on the time im not there unfortunately.

After the first treatment he was much worse
After the second treatment the headshaking went for about 7 days and then returned getting gradually worse until the 3rd treatment which was 3 weeks after the 2nd.

Just got to see how long it stays away for this time.

The vet did say that how they react and the length of time that the headshaking subsides for after the 3rd PENS treatment is usually as good as it gets.

So although there is a possibility of doing a 4th treatment, it the headshaking only subsides for say 1 week, 2 weeks, 1 month etc after the 3rd treatment then it will most likely only subside for the same amount of time after the 4th. Although I did think as he reacted negatively to the first one, but responded to the second one as some have done to the first one that perhaps hes almost like a treatment behind!? who knows...

Got rather upset during the treatment as i felt i had to ask the question 'how and when would you recommend that enough is enough and the suffering is too much to continue' Literally hadn't left myself think about this up until that point as I cant bear to lose him - yet I know this is realistically something I may have to face :( .

Fingers crossed (everything crossed!!) that this 3rd treatment has a longer lasting effect or reduces it in some way so that I can manage it so that he can be comfortable (gave up on the idea that he might recover enough to be ridden, but ultimately if he can mange as a companion with the occasional walk in hand round the village for a change of scenery without being in discomfort all the time then i will take that any day.

Discussed also the possibility of a drug trial is the PENS is unsuccessful although i'm not sure what specific trial it is -he said its incredibly expensive and again not sure if it will work - but we will try!


It just makes me so angry and sad that these poor animals have to go through this and there's nothing that can be done to help :( I wish I could swap places with him and have it instead!

Even though its only been a few days and i know that it will come back,its been so nice just to be able to bring him in and give him a groom without the distressing headshaking - just praying it goes for months rather than weeks, probably wishful thinking rather than realistic expectations given how hes responded so far, but trying to keep positive!

Will keep this updated on how we get on.
 
Cascada, I was wondering how you were getting on! So pleased to hear that he has improved again, will keep all things crossed for you that it lasts months. I know what you mean about the 4th treatment - perhaps it may be necessary with him to get the full benefit from the PENS - it seems that there's no hard and fast pattern to the response so maybe yours needs another go...

Thank you for all the updates, it's really helped - when I went to the vets last week I felt I had a better understanding of what to expect if the PENS was something they had wanted to try, without your posts I would have been much less informed.

My wonderful boy will be put down tomorrow morning. My heart is broken but I am 100% sure that it's the right thing to do. He's had a nice week out in the field with more carrots than he's had in his life (his favourite) but his twitching etc has been very apparent and yesterday it was snowing finely but like icy needles and he couldn't cope, I had to rescue him as he was galloping round trying to scrape his head on the floor. I had to hold a towel round his nose/face so he didn't run me down trying to hide in my coat....
Tomorrow can't come too soon yet I never want it to come in equal measures...

Let's hope that one day in the future we'll look back and think "if only they'd known that when our boys were suffering" and this horrible condition is manageable for all or better still, that there's a cure....
 
Cascada, I was wondering how you were getting on! So pleased to hear that he has improved again, will keep all things crossed for you that it lasts months. I know what you mean about the 4th treatment - perhaps it may be necessary with him to get the full benefit from the PENS - it seems that there's no hard and fast pattern to the response so maybe yours needs another go...

Thank you for all the updates, it's really helped - when I went to the vets last week I felt I had a better understanding of what to expect if the PENS was something they had wanted to try, without your posts I would have been much less informed.

My wonderful boy will be put down tomorrow morning. My heart is broken but I am 100% sure that it's the right thing to do. He's had a nice week out in the field with more carrots than he's had in his life (his favourite) but his twitching etc has been very apparent and yesterday it was snowing finely but like icy needles and he couldn't cope, I had to rescue him as he was galloping round trying to scrape his head on the floor. I had to hold a towel round his nose/face so he didn't run me down trying to hide in my coat....
Tomorrow can't come too soon yet I never want it to come in equal measures...

Let's hope that one day in the future we'll look back and think "if only they'd known that when our boys were suffering" and this horrible condition is manageable for all or better still, that there's a cure....


Thank you - yes they did say that really the 4th PENS and onward is an area they just dont know and they cant really advise on anything so just have to see.

Ive found this forum really helpful as well, I wish that none of our lovely horses have to go through anything like this, but its nice to be able to discuss it in a place where (unfortunately) others know what we are going through.

I just hope that all the cases as they continue to trial treatments may result in a more effective and long lasting treatment for this condition!

Oh, my heart goes out to you it really does :( Such a horrible thing to have to go through, but you know your boy and you know that you are doing the right thing for him to let him finally be at peace. You know that you have tried everything you could have, but at the same time when you can tell hes suffering there has to be a point where you decide that its no longer fair to keep putting him through different treatments etc. You are doing the right thing 100% by the sounds of it for your boy, at least you can take some comfort from that.

I will be thinking of you tomorrow morning :(
 
Oh, my heart goes out to you it really does :( Such a horrible thing to have to go through, but you know your boy and you know that you are doing the right thing for him to let him finally be at peace. You know that you have tried everything you could have, but at the same time when you can tell hes suffering there has to be a point where you decide that its no longer fair to keep putting him through different treatments etc. You are doing the right thing 100% by the sounds of it for your boy, at least you can take some comfort from that.

I will be thinking of you tomorrow morning :(

Thank you, much appreciated :)
 
Just read through this thread with interest as I have just returned from Langford with our cob who had a headshaking workup with Veronica Roberts yesterday.

I've posted a thread about our experience so far.

Dazed'n'confused, I'm so so sorry to read that your boy is being pts tomorrow. I will be thinking of you. Headshaking really is the most frustrating, heartbreaking condition I have ever dealt with. Take care of yourself, you are making a brave decision with your boy's welfare at heart.
 
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