Menopause Matters Forum
Menopause Discussion => Other Health Discussion => Topic started by: misskh on September 29, 2016, 11:17:02 AM
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Hi there...I've been scrolling through the Internet including MM for days now and I'm still at a loss.....So wondered if anyone could help?
Over the August bank holiday I tested positive for a UTI....have no clue what caused this one....normally having sex but that's a distant memory... and was given a 7 day course of Trimethoprim...... Sample showed I still had the infection so I was given a 5 day course of Nitrofurantoin....next sample was clear of infection . I then got a bout of thrush so the Dr prescribed Canestan duo...pessary and cream...this cleared up the symptoms but they returned so I bought another Canestan duo....This eased the symptoms but hasn't cured the problem...... I'm only sore on the outside of the vagina, feels more like burning....no discharge or odour with this or first the bout of Thrush.
I'm also suffering with a dull lower stomach ache....well more discomfort than pain.
Applying the Thrush cream does sometimes ease the soreness sometimes but it doesn't shift it all together...Tummy discomfort stays... Always wear a skirt at home....sometimes no underwear.
For the last week I have been taking Acidophilus....a Lactobacillus friendly capsule daily and an Actimel drink to try and redress any inbalance caused from taking Antibiotics....
I'm also prescribed Vagifem which at the moment I'm not using as I'm not sure if its ok to do so.....if I'm honest I don't take this as frequently as I should as even inserting this can cause me to be sore as I'm so dry down there.
As my samples are clear and the Thrush cream isn't shifting the soreness completely I'm beginning to wonder if I'm suffering from something completely different..maybe Tummy and Vagina pains are connected..... maybe not....Maybe some other kind of problem . I have in the past had this soreness....although not Thrush.... and the wishy washy tummy feeling....had a scan last year... ovaries rather shrivelled....so I'm told.
Really just wondering if anyone has any advise they can offer or any other products I can try that may stop the discomfort.
Just to add I'm 53 and not sexually active due to incredible vaginal dryness normally which normally causes the UTIs.
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Hi misskh,
If you were supplied Vagifem then I would use it. It sounds like you may have Vaginal Atrophy. There are lots of threads on here about it, so type it into the search engine and have a read. I'm sure someone will be along soon to advise you, in the meantime, have a read of this.
http://www.menopausematters.co.uk/article-vaginal-atrophy.php
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Sorry to hear about this and it is a common problem for menopausal women. Whether or not you still have an infection (there are lots of threads about this!) it does sound like you have vaginal atrophy and really do need to start the vaginal oestrogen as soon as you can. I understand from other women that insertion is often sore to start with so hopefully others who have suffered in this way will be along to offer advice. Dancinggirl is the resident expert on this - and Maryjane! There are other types of local oestrogen which you could start to use externally and around the inner parts. This is Estriol cream or ovestin. Although they are normally applied using an applicator, initially you could just use your finger to coast around the outside and inside of vagina - as far as comfortable - every day for a fortnight (the usual loading period) or longer until you felt more comfortable. This will plump the tissues up. Please do go to the doc and ask for this as well as the Vagifem. Some women need full HRT as well as local oestrogen in order to keep VA at bay (and vice versa ie some women like myself even tho' on full HRT for other menopausal symptoms, need local oestrogen as well to keep the vaginal tissues healthy).
There is a thread called the Burning Club here which you might like to read!
http://www.menopausematters.co.uk/forum/index.php/topic,22886.0.html
Hurdity x
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PS :welcomemm: !
Hurdity x :)
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Hi Misskh, Hurdity is correct is does sound like VA , having been ( and always shall be ) a fellow sufferer
I use vagifem and Ovestin externally and I'm also on full Hrt to stave away any soreness.
Vagifem must be used regularly and it is recommended to begin with a 2 week course every night then I do twice weekly
Mine started very much like yours with recurring uti's mine got so bad I found it difficult to walk and wear knickers !
The soreness does eventually go , although you may not think it now !
There are many knowledgable ladies on here who also suffer from this complaint .
I personally have found it better to shower rather than bathe and I also only use Dermol to shower with , try and go knicker less whenever poss and I never wear tight jeans
Hope this helps , and you're feeling better soon
❤️❤️❤️Ss X
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Thank you... does sound like it could be this...
I'll start back on the Vagifem today......Not sure whether to do the one a night for a week then twice weekly....as per first off..or just twice weekly.
I always shower and never use soap/shower gel down there.
I was wondering if I should also buy the Multi Gyn Actigel to use.....would you recommend this as well?
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Nope or you won't know what is working.
If you are very dry down there, then using KY Jelly several times a day will help. Gently on the outer lips and as far in as possible until the skin feels supple.
As oestrogen levels drop the body dries up: skin, eyes, deep in the ears, nostrils, vagina …….. and if the skin in the vagina dries it becomes itchy and can invite infection.
If you have difficulty inserting Vagifem: which needs application every night for 2 weeks then every 3rd and 5/6th night thereafter: for ever; then lay quietly on the bed after a *bath* and insert KY as far up as possible. That will ease the vaginal lips open and eventually you can insert the Vagifem.
Although ladies find showering keeps symptoms at bay, I bath every night ……. I have never had problems with oils or soaps other than those 'cubes' that fizz. They had me leaping out of the water :o even B4 I had sat down ……. 'simple' products can be useful all over the body. The vagina needs cleansing the same as the rest of the body.
I also drink Actimel to try and keep my innards healthy. I also swear by 'live' yoghurt applied down below ;-)
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Thank you CLKD.
For some reason KY Jelly doesn't suit me...I find it dries out.....so I have bought something called Sylk which is supposed to be just a lubricant and quite safe so I shall try that.
Do you have set days when you apply Vagifem...... eg Monday/Thursday or do you follow the every 3rd and 5/6th day routine?
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Sylk has a good record too. I was prescribed Ovestin1mg which is applied with an applicator. After my initial 2 week nightly loading, I have to tick the calendar ::) to remember - I can go 3-4 nights between use and it does depend on whether I am home/not. So I tend to count 3 and 5 nights between …….
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My Vagifem routine is Tues/ Saturday I also use Hydromol each night on the outside
💚💚💚Ss X
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:thankyou:
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Sorry to hear about this and it is a common problem for menopausal women. Whether or not you still have an infection (there are lots of threads about this!) it does sound like you have vaginal atrophy and really do need to start the vaginal oestrogen as soon as you can. I understand from other women that insertion is often sore to start with so hopefully others who have suffered in this way will be along to offer advice. Dancinggirl is the resident expert on this - and Maryjane! There are other types of local oestrogen which you could start to use externally and around the inner parts. This is Estriol cream or ovestin. Although they are normally applied using an applicator, initially you could just use your finger to coast around the outside and inside of vagina - as far as comfortable - every day for a fortnight (the usual loading period) or longer until you felt more comfortable. This will plump the tissues up. Please do go to the doc and ask for this as well as the Vagifem. Some women need full HRT as well as local oestrogen in order to keep VA at bay (and vice versa ie some women like myself even tho' on full HRT for other menopausal symptoms, need local oestrogen as well to keep the vaginal tissues healthy).
There is a thread called the Burning Club here which you might like to read!
http://www.menopausematters.co.uk/forum/index.php/topic,22886.0.html
Hurdity x
Hurdity What is the difference between Estriol and Vagifem? I do have a tube of Estriol which i got last year (unopened and ok until early 2017) so I think i will try and use it. i will try the suggestion of using a finger first. How much should I try to use each time? Do you part fill the applicator?
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I have the same problem remembering when I've taken them....then I get waylayed and weeks go by without using any....
Think I'll do the first 2 weeks at one a night and then maybe do as Sweetscarlett does and have set days... it'll be easier to remember.
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Vagifem is Estradiol so different estrogen but they do the same job...Huridity can correct me if I am wrong :)
kateJo.... Is there a line on the applicator? I know there is on the Ovestin one, if so fill it to there.
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Hi😊I unfortunately suffer badly from this heinous condition.
Re insertion ......dip the vagifem in the sylk bottle ( no hygiene worries as disposable ) lie on your back raise your hips , breath out as you insert and should be pain free.
I need vagifem 5 xs a week , PLUS ovestin on the outer bits as and when PLUS multi-gyn PLUS V-magic which i use between the outer and inner labia to keep it supple PLUS systemic HRT. ALL for my flipping vagina/ vulva/ bladder.
Not ONE hot flush , this started at 47 now 50.
Wish I was an expert on dodgy knees TBH.
Also some ladies do also need a temporary course of steroid cream for the area , oitment not cream but this is more specialised , as VA can and does very often run along side other conditions , like vulva excema, dermatitise, Lichen Scerlose the list goes on. Good luck .
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Vagifem is Estradiol so different estrogen but they do the same job...Huridity can correct me if I am wrong :)
kateJo.... Is there a line on the applicator? I know there is on the Ovestin one, if so fill it to there.
Yes absolutely! They are designed to do the same job at the same dose (approx!).
katejo - re the expiry date for HRT patches and creams etc - there is really no need to worry unduly about this - I mean it's not going to be OK one day and off the next just as in food. I am still using utrogestan (progesterone) that is almost 2 years past its expiry date and it still works fine! Hope the discomfort starts to ease soon...
Hurdity x
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Hurdity.....I thought estriol was much weaker than Ovestin ? as told by gynae.
Roughly 10 xs weaker ?
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Yes that's right but the amount used is 10x less of Ovestin so I understand. I did read this somewhere. I haven't used Ovestin but apparently the applicator is very small - gives only 0.5 g of cream! The Gnest applicators are huge and give much larger dose of cream. I said same dose not same amount! Sorry in a hurry must dash!
Hurdity x
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I had this problem - the last time I had vaginal antibiotic cream, but the swab came back clear, so was told to use the vagifem.
It is hard to see how it works, but it really does, and I have not had a problem since.
Use it every night for two weeks. This is important - I got that bit wrong too ::)
Thereafter, use it twice a week (some health authorities say use alternate nights for a further 2 weeks, which is what I did eventually).
I use it every 3 days - I have never got away with less.
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I had this problem - the last time I had vaginal antibiotic cream, but the swab came back clear, so was told to use the vagifem.
It is hard to see how it works, but it really does, and I have not had a problem since.
Use it every night for two weeks. This is important - I got that bit wrong too ::)
Thereafter, use it twice a week (some health authorities say use alternate nights for a further 2 weeks, which is what I did eventually).
I use it every 3 days - I have never got away with less.
So you use it every 3 days on a continuous basis (not just for a further 2 weeks)? It does appear to have done some good. I have been using Estriol cream nightly for 4-5 nights now and the discomfort has faded/improved but not quite gone completely.
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Every 3rd night. Continually. For ever otherwise symptoms do return!
Symptoms may take a while to ease but should lessen sooner rather than later, if it's annoying then do 3 continual nights then a break of 2 ………
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Every 3rd night. Continually. For ever otherwise symptoms do return!
Symptoms may take a while to ease but should lessen sooner rather than later, if it's annoying then do 3 continual nights then a break of 2 ………
It isn't that it is annoying. Just that I need to know when I have to ask the GP to give me a repeat prescription.
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It should be on repeat without your asking ::)
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It should be on repeat without your asking ::)
I will still have to ask for this to be set up. I was given the prescription a year ago to try out. I have enough for the moment until i see a GP again at the end of this week or the following week.
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Crikey, I hope that you have enough :o …….
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Crikey, I hope that you have enough :o …….
I have enough until my next appt.
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Hi there...I've been scrolling through the Internet including MM for days now and I'm still at a loss.....So wondered if anyone could help?
Over the August bank holiday I tested positive for a UTI....have no clue what caused this one....normally having sex but that's a distant memory... and was given a 7 day course of Trimethoprim...... Sample showed I still had the infection so I was given a 5 day course of Nitrofurantoin....next sample was clear of infection . I then got a bout of thrush so the Dr prescribed Canestan duo...pessary and cream...this cleared up the symptoms but they returned so I bought another Canestan duo....This eased the symptoms but hasn't cured the problem...... I'm only sore on the outside of the vagina, feels more like burning....no discharge or odour with this or first the bout of Thrush.
I'm also suffering with a dull lower stomach ache....well more discomfort than pain.
Applying the Thrush cream does sometimes ease the soreness sometimes but it doesn't shift it all together...Tummy discomfort stays... Always wear a skirt at home....sometimes no underwear.
For the last week I have been taking Acidophilus....a Lactobacillus friendly capsule daily and an Actimel drink to try and redress any inbalance caused from taking Antibiotics....
I'm also prescribed Vagifem which at the moment I'm not using as I'm not sure if its ok to do so.....if I'm honest I don't take this as frequently as I should as even inserting this can cause me to be sore as I'm so dry down there.
As my samples are clear and the Thrush cream isn't shifting the soreness completely I'm beginning to wonder if I'm suffering from something completely different..maybe Tummy and Vagina pains are connected..... maybe not....Maybe some other kind of problem . I have in the past had this soreness....although not Thrush.... and the wishy washy tummy feeling....had a scan last year... ovaries rather shrivelled....so I'm told.
Really just wondering if anyone has any advise they can offer or any other products I can try that may stop the discomfort.
Just to add I'm 53 and not sexually active due to incredible vaginal dryness normally which normally causes the UTIs.
You use vagifem every night its not used like a panadol but like the pill was
With every passind day you use it the dryness will be replaced by wet moisture
In a week or 2 it will slide in like butter. ATROPHY IS DRYNESS THATS THE FIRST SIGN
PLEASE USE YOUR VAGIFEM ASAP YOUR SYMPTOMS WERE EXACTLY 100% LIKE MINE THRUSH THRUSH THRUSH PILL AFTER PILL DIFFERENT INES ONE LOT I TOOK FOR 3 MONTHS . YOUR SYMPTOMS ARE VAGINAL ATROPHY XXXX GET HELP ASAP
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:thankyou: Suzi Q!
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Clkd bunny hunch xxxxx :-* :-* :-*
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:)
I had itching high up yesterday >:( and thought "Oh! No!" but it's OK today. No rhyme nor reason ::)
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CLKD, I know what you mean ,I still get iffy days here and there ,it frightens you
Glad it's ok now
💙💙💙Ss X
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Thanks. I hate having an itch that I can't reach ::)
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Every 3rd night. Continually. For ever otherwise symptoms do return!
Symptoms may take a while to ease but should lessen sooner rather than later, if it's annoying then do 3 continual nights then a break of 2 ………
I am now baffled. Last Friday I decided to start the Estriol because the AB seemed not to be working (already day 4 of 5 and no improvement). I got an 'apparent' almost immediate improvement and so thought that I was benefitting from the cream. Then during last night UTI like symptoms came back. I don't yet have the result of the urine test done on tuesday (when I felt ok). If the cause is VA rather than UTI, is it normal for the symptoms to come and go? I have been applying it every night before bed.
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Yep. This is why it is important to continue with the medication. If ABs haven't helped after that time then it's most likely vaginal atrophy.
Sometimes in the 24 hours after I used Ovestin I would get symptoms which would then ease.
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Yep. This is why it is important to continue with the medication. If ABs haven't helped after that time then it's most likely vaginal atrophy.
Sometimes in the 24 hours after I used Ovestin I would get symptoms which would then ease.
Yes but after being symptom free for 3-4 days, it came back. That made me wonder whether i had needed the AB after all but it hadn't completed the job. You mean that you take Ovestin in the evening and then may have symptoms during the following day until you take it again? I will hopefully get my test result tomorrow morning.
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Ovestin1gm is inserted into the vagina, not 'taken'. The initial load is for 2 weeks then every 3rd and 4/5th night. When I had the problem initially, after the 3rd or 4/5th night of use, I would have low belly heaviness the next day. I would think "It's back, the product isn't working" ::) but now I don't get those symptoms.
Does 'Estriol' stay inside all the while?
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Ovestin1gm is inserted into the vagina, not 'taken'. The initial load is for 2 weeks then every 3rd and 4/5th night. When I had the problem initially, after the 3rd or 4/5th night of use, I would have low belly heaviness the next day. I would think "It's back, the product isn't working" ::) but now I don't get those symptoms.
Does 'Estriol' stay inside all the while?
yes my word taken was just a loose term for use. I suspect the cream doesn't stay inside long. However why would the symptoms disappear completely for 3 to 4 days and then return. It feels like a uti. It's more than just heaviness.
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It takes time for the tissues to respond, hence the 2 week loading. Once your tissues are ok, then it is much more stable and you learn the early signs of when it isn't working and you need a bit more. You might find that the 2x weekly is not quite good enough. I use mine (vagifem) every 3rd day but went though a phase of not managing so using it every other day (prescription said 1 or 2 twice a week, so was happy that was within what I was told) As time goes on, it gets more stable.
I expect you may have uti-like problems until it settles. I know I did with thrush, which is why I had to get tablets and the Actigel a couple of times.
To start with, it can be a bit up and down.
Not sure I am making any sense here ::)
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Come to think about it - I got into a muddle with my first packet, the doctor I saw after that said that that it was just a tiny amount of oestrogen, so to reload again, and get it to feel right.
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Come to think about it - I got into a muddle with my first packet, the doctor I saw after that said that that it was just a tiny amount of oestrogen, so to reload again, and get it to feel right.
Finally got urine test result today and do still have bacteria so have been given a different AB. Will continue with Estriol cream as well. Have GP appt next week. Am also trying D Mannose .
Am holding back from taking the AB because the symptoms have mostly cleared up. Perhaps the D Mannose is having some effect.
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Did the result show which Anti-biotic should be prescribed? It really can be Trial and Error until we find a regime which suits as each vagina is different ;)
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Did the result show which Anti-biotic should be prescribed? It really can be Trial and Error until we find a regime which suits as each vagina is different ;)
I can only say that the GP prescribed me an AB based on my result. I only spoke to her on the phone.
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How R U today?
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How R U today?
[/quocte] Am fine today so still holding off AB. Used Estriol last night and took D Mannose too. Will discuss with GP on Wednesday.
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Let us know how you get on?
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The lady who started the thread seems to have disappeared :-\
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Let us know how you get on?
I saw the GP today and did get a further prescription for more Estriol but only with a warning of cancer risks. She would have preferred me to just use a non hormonal jelly. I thought the cancer risk was reduced with a local application/hormone?
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Change your GP? or refer her to MM Forum! She's using old excuses to cut costs probably >:(
Give the Surgery a ring and ask for copies of the 'cancer risks' that this particular GP feeds you, i.e. Calls for Papers, Abstracts, Peer Reviewed Research …….
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Change your GP? or refer her to MM Forum! She's using old excuses to cut costs probably >:(
Give the Surgery a ring and ask for copies of the 'cancer risks' that this particular GP feeds you, i.e. Calls for Papers, Abstracts, Peer Reviewed Research …….
She's not my actual allocated GP. I have seen her recently partly because I generally prefer her to a couple of the others and partly because she is best of the doctors who do the appointments booked online. My allocated GP never does these. I rarely see her. I much prefer booking online as it is much easier to get a convenient date/time. i don't like booking via the receptionists.
She took me by surprise and i didn't have any facts on hand to present to her.
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Did she tell you that she 'prefers' a non-hormonal jelly :-\. It isn't what she 'prefers' but what is best for her patients. :sigh:
What's the problem with booking through the receptionists? Here it can take ages to get through in the morning on the phone ::) which is why, dinosaur that I am, resisted going on-line to book appts. At least it means I can book well ahead and as long as I can find my password ………..
Also, make an appt. B4 your medication runs out.
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Did she tell you that she 'prefers' a non-hormonal jelly :-\. It isn't what she 'prefers' but what is best for her patients. :sigh:
What's the problem with booking through the receptionists? Here it can take ages to get through in the morning on the phone ::) which is why, dinosaur that I am, resisted going on-line to book appts. At least it means I can book well ahead and as long as I can find my password ………..
Also, make an appt. B4 your medication runs out.
Yes she does prefer non hormonal jelly. I have bought some of that and it may do some good.
Because the time to ring in the morning if there is any urgency is only between 8am and 9am. This is the time when I am travelling to work and am on the tube so no phone calls possible. Also the receptionist has more control over the time/day offered to you. It is often very inconvenient for anyone who works in Central London. The practice online booking used to be a waste of time and effort but it has much improved lately. There are usually about 5 possible appointments over the next 5-10 days.
Yes I did get an appointment before the Estriol ran out.
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Sounds pretty like all over the UK then :bang:. At least I am able to walk the few moments and sit in the waiting room until seen if really necessary - as I did when panic attacks over-took me a few years ago. They could see how ill I was feeling.
Let us know how you get on! A GP shouldn't tell a patent what he/she prefers to prescribe ………. >goes away muttering<
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Sounds pretty like all over the UK then :bang:. At least I am able to walk the few moments and sit in the waiting room until seen if really necessary - as I did when panic attacks over-took me a few years ago. They could see how ill I was feeling.
Let us know how you get on! A GP shouldn't tell a patent what he/she prefers to prescribe ………. >goes away muttering<
On occasions when i need an urgent appointment I do walk there rather than try to phone. However they sometimes seem determined not to give any real advantage to those in the queue. Despite my need to travel to work, I get told to go home and come back in about 2 hours.
However, now that the online booking has so much improved, I am less likely to try for the same day. It used to be so difficult to get any advance appointments at all so same day was the only option.
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Our Surgery now opens at 7.30 two mornings a week for those who are in work, they also have 1 late night Surgery a week - for employed people.
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Our Surgery now opens at 7.30 two mornings a week for those who are in work, they also have 1 late night Surgery a week - for employed people.
Mine doesn't have any appointments earlier than about 8.45. There are some evening ones but I haven't been offered them.
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How are symptoms 2-day and where did the original poster go :-\ ???
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How are symptoms 2-day and where did the original poster go :-\ ???
[/quo4te] No symptoms now. No idea about original poster.
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That's good - hopefully symptoms will remain gone!
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How are symptoms 2-day and where did the original poster go :-\ ???
I'm here....I've been so busy of late and was always going to "log in later".... Only later seemed to flash past.
CLKD...your message booted me back into gear.....but for reasons unknown to me I'm not allowed to send PMs! So can't messagd back.
Must make a point of checking the forum daily as the info on here is a god send.
I'm still using the Vagifem twice weekly....but haven't had full blown passion as of yet....I really fear UTIs coming back, silly as who knows it may not be a regular occurrence if I keep taking Vagifem but the thought makes me clamb (sp) up :( Things may be improving as I can actually insert the tube now without things feeling too dry as even this was a problem before.
I would like to stick to using it on 2 set days as I lose track and thats when it all goes Pete Tong and I totally forget. I still feel a fizzing, for want of a better word, when I insert a tablet is this normal?
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Good to hear you are getting on ok.
I am not sure about fizzing; but I came to vagifem via the route of constant vaginal 'infections'. So if I am not feeling wet and swollen (to be contrary) then I know the vagifem is working.
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Thanks for the update. You probably haven't posted 'enough' in order to enable PM facility.
As well as my VA treatment we use plenty of lube prior to being intimate ;-). As well as not rushing into it.
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Evening....
I too thought that maybe I hadn't posted enough messages to be able to send PMs.
I've started using a product called Sylk that seems to suit me better than KY did, although I'm not sure if my local Chemist still stocks it so may have to find another supplier.....Or another lube.
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You can buy it online or at boots, but my local chemist always has a bottle - it is available on prescription now so probably more likely to be stocked locally now. There is also Yes online who also do a moisturiser. Sometimes I just use the Actigel - but it is not lube really ;D
There was a thread about an article about moisturisers and lubes recently, showing the different pHs and another factor which showed how likely they were to irritate. http://www.menopausematters.co.uk/forum/index.php/topic,33327.0.html
They all seem to have redone their packaging recently - much prettier ;)
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The link to the Panay article doesn't work any more - I can see what Maryjane has written in the thread but not where it goes. Could anybody repost please? I missed that at the time.
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Even if my Dr gave me it on pprescription my pharmacy would charge me full price...... When I had thrush not long ago Dr gave me Canestan duo on a prescription but he said as it was available over the counter I'd have to pay £14.95......if i wasn' feeling so rubbish I'd have told him where to shove it. Haven't seen it in my local Boots but I'll check when next passing.
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misskh - as Canesten Duo counts as two items (tablet and cream), I was told that you have to pay two prescription charges. It works out slightly cheaper if you buy it over the counter.
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Ancient runner - as requested from Maryjane's previous post:
http://www.tandfonline.com/doi/full/10.3109/13697137.2015.1124259
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Canestan Duo caused intense pain and discomfort …….. so knew then my problem is VA.
Most intimate products are available in large Dispensaries/Chemists.
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CLKD.... That's what they said.
I was just surprised as you can purchase each item separately but as the Dr felt I needed the duo and it comes as one packet it should be charged as one pack.
I wonder if the Dr's know, if so I wonder why they give out a prescription for it to a person who has to pay.
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Thanks Jenna! Interesting reading...
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Our GP would suggest buying the product over the counter ::)
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You're very welcome, ancient runner! I'm just relieved that I use Yes water-based as a daily moisturiser (apart from when using the Estriol Cream twice a week!).
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Ah yes - the multiple prescription charge - also applies to sequi hrt and if you want a pair of surgical stockings ::)
More examples:
http://www.well.co.uk/globalassets/misc-docs/psnc_multi_charge.pdf
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Ah well....it's done now. Learn something new.