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Letrozole Side Effects

Angel62
Member

Re: Letrozole Side Effects

Hi ladies i have been taking letrozole for 4 months and as I stated earlier the side dffects in he last few weeks have been horrendous and I couldn't cope with the low mood. I dud a lot if research and asked my doctor to take me off Cipla and put me on Accord after my research on this forum. I know it's early days and only been taking accord brand since Wednesday but already feel like I'm back to my old self, no joint paint, no sweats, no depression, appetite back so onwards and upwards at last fingers crossed. I'm also sleeping like a log again but doing stretching exercises before bed and sleeping with my feet raised on a cushion....peeeeerfect
Angel62 x
Conanthelibrarian
Member

Re: Letrozole Side Effects

Hi

 

i am finding that I get mottled skin and have a small reddened area on my (good) breast. I have been on Letrozole for just over the year and am getting appalling side effects. I’ve been referred back to the Breast Clinic tomorrow to get it checked but having had a recurrence on my bad side last year I am very worried.

 

Has anyone else experienced skin problems?

 

Anne

Conanthelibrarian
Member

Re: Letrozole Side Effects

Hi

 

i am finding that I get mottled skin and have a small reddened area on my (good) breast. I have been on Letrozole for just over the year and am getting appalling side effects. I’v Been referred back to the Breast Clinic tomorrow to get it checked but having had a recurrence on my bad side last year I am very worried.

 

Has anyone else experienced skin problems?

 

Anne

Corrina
Member

Re: Letrozole Side Effects

my memory is so bad so wander if im getting a brain tumour or the cancer has spread xxc                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          

Corrina
Member

Re: Letrozole Side Effects

ive been off letrozole for a couple of weeks now. sill feeling extremily tired  and having memory problems going to go to see my GP next week to discuss. sometime having real bad swets in the night xx

GrumpyTrout
Member

Re: Letrozole Side Effects

One of my happier discoveries is that dark chocolate is a good source of magnesium. I believe that most minerals and vitamins are better absorbed via food than as chemical supplements.

Happyboobs2
Member

Re: Letrozole Side Effects

Hi, I am also the same age ish as you . I have taken Letrozole for over 2 years now. For the first couple of months I had heavy night sweats, absolutely drenching and also woke up very sluggish and with a headache.

I put a lot of that down to being dehydrated because of the sweats. After a couple of cups of tea and breakfast the headache went quite quickly.

These days I am still slow to get going in the mornings, it doesn’t matter much as I am retired but I feel for those ladies who work or have families to see to.

The joint pains in the early days were quite bad, throbbing ankles I remember.

I still have joint stiffness which obviously hurts but once I get going it helps although several times a week I resort to paracetamol or ibroprufen.

I don’t feel I could stop the Letrozole  as I want to give it my best shot but we are all different aren’t we?

Please read the threads about the different manufacturers of Letrozole. I believe a lot of ladies struggle with Cipla , that’s what I started with, I changed to Actavis and now am sticking with Accord.

Its a big learning curve!

All the best

xx

 

angabb54
Member

Re: Letrozole Side Effects

Hi Jelsey2012,

 

Hope you are feeling ok after your mastectomy, I am same age and was put on Letrazole 2and a half years ago after my mastectomy.

 

I have stopped Letrazole until I see a Consultant next week as I have had some bad side effects mentioned in previous threads.

 

 I would say that’s exactly how it feels, unable to wake and get up normally, sluggish, headaches, tired, painful  joints etc. I felt exactly the same. It’s a weird feeling, not feeling yourself and as I described it feeling a bit ‘drugged’and heavy.

 

Advise you to keep tabs on the brand they are giving you, as I thought I was ok and got on with dealing with the SE as we women tend to do, I did suffer side effects, but it did get a lot worse after I was given Cipla brand....

 

Good luck xx

 

 

Jelsey2012
Member

Re: Letrozole Side Effects

Hi - I am new to this. I had a mastectomy in August and have been on Letrozole for about a month. I do get aches in my joints but the worst for me is being unable to wake up in the mornings. Then feeling so headachy and sluggish. Is this normal? I am 63 so past menopause. Any advice welcome. 

 

Nannyannie
Member

Re: Letrozole Side Effects

Hi Corina

i was on letrozole for 6 months. Started mid .feb. Taken off 6 weeks ago because of SA, the worst being the way it messed with my head. Severe depression anxiety and multiple panic attacks. Have now been put on exemestane. Took my first one today and keeping my fingers crossed that they suit me better. They are not the generic kind and looking up the price via GP prescribing was gob smacked to find they cost £88 per month. If they’re no good at that price nothing will be. Here’s hoping!! Xxx

Kate21
Member

Re: Letrozole Side Effects

Hi again, I agree about animal oestrogen! Although I have never been much of a meat eater I gave it and dairy up when I got my diagnosis, apart from a little goats milk in my one or two cups of tea a day and an occasional roast lamb dinner, and I can't remember the last time I had one of those! Do think cow is the worst culprit from what I've read. Funny though, I have made many changes but giving up my cuppa was a step too far! Please let me know what you think when you've looked into it, be very interested to know xx 

angabb54
Member

Re: Letrozole Side Effects

Hi Kate..I will definitely check that out..am thinking that animal oestrogen should be limited and that will include dairy I imagine. I will look into into it..seeing consultant on 23rd this month. It's been a month since I stopped taking  Letrazole. My husband has even said my driving is better ! Xx

 

Kate21
Member

Re: Letrozole Side Effects

Hi Angabb54, please double check this but I looked into oestrogen and diet and believe plant oestrogens behave differently and are okay....as I said please don't just take my word for it but that is how I understood it x

KayEM
Member

Re: Letrozole Side Effects

I can’t sleep at all since I started Letresole 4 months ago! I take Ambien but that’s not working now
angabb54
Member

Re: Letrozole Side Effects

Hi girls..it's good to know that there are alternatives to taking Letrazole...I'm off it 3 weeks this Sunday and my side effects are definitely subsiding. I too had poor memory and concentration issues, but the worse thing was the awful fatigue and pain in joints..I felt as if I was dragging myself through life and everything was such an effort. Horrible...keep chins up. Xx

Corrina
Member

Re: Letrozole Side Effects

Hi angabb54 I only stopped taking letrozole on Friday and already feeling much better  Im not as tired and my mood has improved ,I will have to make an appointment for a review of my medication in 5 wks . I would love it if they said my risk was s low they didnt think it was necessary to take it x

 

Corrina
Member

Re: Letrozole Side Effects

Hi Rosarty dont know if you still come on here. I have just came back on the forum after having a break. I have now been on Letrozole about 8 months. I have been feeling very tired and falling asleep a lot and my mood has been very flat. also sometimes get night sweats and Im still having memory problems ..and find it hard to think straight sometimes which makes managing my job very difficult. I have recently been advised to come off the Letrozole to to see if my symptoms improve, I have only been off them since Friday and Im feeling better already. They have told me toring back up after I have been off them for 5 weeks and if Im feeeling better they will arrange an appointment for me to discuss a change of medication xx

Alieck
Member

Re: Letrozole Side Effects

Hi Angabb, I think there are three main hormone therapy or aomatse inhibitors for post menopausal women being Anastrozole, exemestane and letrazole.  The minute I mentioned the side effects to the Oncologist  he told me that there were plenty of other options and gave me the exemestane instead.  So far the pain has eased and although not gone completely I am able to move about more freely.  Cross fingers.

Helzie
Member

Re: Letrozole Side Effects

Although I posted in the thread that I've suffered no real side-effects from taking Letrozole (apart from gaining a few pounds-lost 11 during chemo!) I've just read on the US  BC site that it can cause heart problems. I'm aware that it can raise cholesterol and since the article didn't elaborate on the causes of the heart problems, am wondering if this is why? Has anyone else info' experience of this? Not too happy if this is the case, as heart before this deemed very good ie when I had the US pre-chemo.

angabb54
Member

Re: Letrozole Side Effects

Hi Pip, Haha excellent that did make me smile!...interesting re magnesium as well as adcal. I've been taking Adcal AND magnesium citrate though not at the same time.  I can't say it's helped me much so far,  but maybe I'll try two tablets rather than one...they are rather large and can get a bit stuck! I now crush mine and add natural yogurt it's so much easier! It's just amazing how much you are not told isn't it..and no one seems to know much about food..(I think I'll qualify too and become a nutritional adviser! ) But I suppose that's the beauty of the Internet! Also feeling a bit cheesed off having checked out foods containing oestrogen in the hope I could perhaps cut out a few instead of taking Letrazole...guess what it's everything I love and have been happily chomping away on for years..all heathy foods too, chick peas, beans, lentils, carrots and.....yes you guessed PRUNES!....Grrrrrrrrr. Almost toooo much information on line I find. Enjoy the rest of your day.

Angi xx

dancingpip
Member

Re: Letrozole Side Effects

 
angabb54
Member

Re: Letrozole Side Effects

Hello Pip, yes we sound similar re diagnosis etc re bone density I am at risk as mother has Osteo in her back. I've been advised to take a bone building pill which having tried in the past also left me feeling wretched with joint pains...reviewing that at the moment. Last night on TV there seems to be new evidence that PRunes are efficacious for bone building! I'm also taking Adcal twice a day.. Guess what I had for breakfast...xx

dancingpip
Member

Re: Letrozole Side Effects

Hi Angi - I think our situation is very similar - I am 63 and post menopausal so Tamoxifen was not suggested.  I also haven't heard of Alison's Exemestane but, in my understanding of the information on the eMC website, https://www.medicines.org.uk/emc/medicine/25862 Exemestane is usually given after 2-3 years of Tamoxifen so that's probably why it wouldn't have been offered to you or me. Do hope that the new tablet sorts out your aches and pains, Alison and that you are soon feeling an improvement - might be worth getting your vitamin D levels checked too.  Best wishes Pip

angabb54
Member

Re: Letrozole Side Effects

Hi Alison, really interesting isn't it..such a small pill with so many horrid is effects..yes getting out of bed really uncomfortable, the stiffness and joint pain have been awful...my side effects already diminishing it's been two weeks since I took it. Await to see what the consultant says...not heard of that one. At my nurses visit she said I could try tamoxifen but I know that is for pre menopausal women and I am 62 and post...so unsure why it was even suggested!..good luck on new pill and let me know how you get on..xxAngi

Alieck
Member

Re: Letrozole Side Effects

Hi Angabb, I have been on Letrazole for 9 months but the side effects over the last two months have been awful, with chronic back pain being the main problem. I have been unable to turn in bed and getting up was also a nightmare.  I spoke to my consultant who believed that it was the letrazole but did send me for a Bone Density scan also.  He said that there are plenty of other things instead of Letrazole and I am now taking Exemestane.  I have only just started talking this so will let you know if the side effects subdue.  Alison x

 

dancingpip
Member

Re: Letrozole Side Effects

Hi Angi - Yes, researching diet and phytoestrogens is my way forward too. Luckily my local Tesco has recently turned 2 aisles over to 'free from' produce and the range of vegan cheeses and puds is amazing. Have you read 'Your Life in your Hands' by Jane Plant? She supported the medical team fighting her aggressive cancer by completely changing her lifestyle & diet - and lived a further 27 years to prove her point! You can buy a cheap second hand copy on-line from AbeBooks. It's worth a look. Your mastectomy surgery will have undoubtedly battered you about - I was offered wide local excision but, in the few days before the deed was done, I asked for an additional meeting with the surgeon to request that, if possible, I kept my nipple because she had been intending to remove that.   She said that decision would be made as she did the op.  I woke up to discover that she had managed it; it now points in a very quirky direction but has lots of character!  You will have gone through much more than I did so be kind to yourself and enjoy not taking the tablets. I'm sure you will soon be feeling so much better and would love to hear all your positive news in the future.    All good wishes Pip

angabb54
Member

Re: Letrozole Side Effects

Hi and thank you for your response..it's good to hear that you are feeling better and able to leap out of bed..I've forgotten what that feels like!..great advice I shall go along with all the questions and also check out my predict figures...sounds like your diagnosis was quite similar to mine..very small tumour and no nodes involved..did you have a mastectomy too?..I've been off Letrazole now for just two weeks and still got joint pains and having trouble getting off to sleep..but I do feel less drugged and more alive I have to say!

My next task is to find out what foods are oestrogen rich and take them out of my diet, interesting about dairy.

especially as I've been trying to top up calcium for my bone density and been making my own natural yogurt!

I've not  had cows milk for years and oat milk is my preferred choice. Thanks for all the and info keep feeling good! XxAngi

dancingpip
Member

Re: Letrozole Side Effects

Hi Angabb54 - Delighted to hear that you may be going letrozole-free. I actually typed up all my questions for my consultant and also took a friend with me to make sure that I didn't forget to ask/understand anything important. I also double checked that, even if drug free, I will still be seen annually by the oncologist and the mammogram team to reassure myself that they will stay on my case for the next couple of years. My tumour had been 2.7cms, 100% HER2 positive but with no lymph node involvement and the predict tool showed minimal long term benefit from taking the letrozole so it made sense to give it up and be free of the debilitating side effects. The half life of letrozole is quite short so you should be feeling an improvement within a couple of weeks. I stopped taking mine in July and 2 months later I am a new person....positively leaping out of bed in the morning and with no more incapacitating joint aches. I have also radically altered my diet - cutting out all dairy (to try to eliminate the growth hormones that are fed and injected into cattle) and I feel much better for hugely increasing my salad / fruit intake. My last problem of acid reflux (a side effect I believe was caused or certainly exacerbated by the letrozole and for which I refused to take omeprazole as prescribed by the hospital ENT consultant) has gone completely! I feel great and I do hope you'll be enjoying a similar improvement soon. I feel quite a rebel - messing up the pharmaceutical company's statistical data by becoming 'non compliant' but, hey, what the heck, I gave it a fair innings,over 3 years and suffered every side effect on the sheet, so I have earned my time off for good behaviour! Wishing you all the very best. Pip
angabb54
Member

Re: Letrozole Side Effects

Sorry that last post was for

dancingpip...still getting used to this forum etc..xx

 

angabb54
Member

Re: Letrozole Side Effects

Hi there thanks for your reply..I note you were told to stop taking Letrazole. Was this because you're risks were so small?  I'm waiting to see a consultant as I mentioned earlier..but been told by a breast nurse doing a fitting for me that 'The panel' had said to stop taking it!...just like that with no further ado. Anyway I shall wait and see the experts and discuss my risks. Hopefully it will not take too long to get the appointment through.

how do you feel now you are off the Letrazole!?

xx

angabb54
Member

Re: Letrozole Side Effects

Hi thanks for your reply..I have now been to the breast nurse..mainly to pick up a new prosthesis as mine was leaking silicone. Whilst measuring me up she said that there had been a multidesignatory meeting of doctors nurses and consultants about my case..i.e. Side effects on Letrazole and they'd decided as my risks were low and the tumour they found was so tiny.... I could stop taking it!?

I was surprised to say the least and said I'd like to SEE and speak with a consultant..I was then told they'd say the same thing as she had just told me! anyway I insisted that they make an appointment with a consultant..as I've so many questions to ask. Really very surprising. Just goes to show that you really do need to be firm on these things..it's my body, I've had a mastectomy and did I need to be on this awful drug at all? I await my appointment and will see what they advise, but will probably be told it's my choice in the end etc....

its been two weeks now since I took my Letrazole and although not feeling tip top I am not suffering as much as I did.

 

Watch this space! Xx

elke nicholson
Member

Re: Letrozole Side Effects

Thank you so much for your reply.

I get, here in Spain, thankfully. the original, so I am on Femara - no generic. And still the nausea. The onc. now gave me Aromasil which I will be taking just before going to bed. Maybe this will help. Have the feeling that he thinks it is psychosomatic - which is possible. Just have to put up with it. All the test were normal and he was, on the whole, very happy with me. One thing I do not want for IT to come bac k.

 

Any other advice from you out there would be much appreciated!

Hugs

Elke

Blueleyla
Member

Re: Letrozole Side Effects

Hi Elke

i have been on Letrozole since January and thankfully not too many side effects. Have you thought about trying a different brand of Letrozole.? I did have one brand Cipla which made me dizzy so went back to the doctor and got another prescription for a different make and it was fine . I was only on Cipla for just over the week. I decided life was too short and we have all been through so much so went to the doctors sooner rather than later. Just a thought, it might help. Hope things improve for you.

elke nicholson
Member

Re: Letrozole Side Effects

Help - has anyone taking Femara/Letrozole got constant nausea?  I have been on it for appr. one and half years, very little bone ache BUT the nausea is not getting better as time goes by but worse.

My oncologist, sadly, does not really want to know: all medications have side effects when asked to give me something.  My quality of life is zero because the sight of food makes me sick.

Have tried ginger tea and travel bands, with no effect.

I would be most grateful.  Or am I the only one???

 

Love to all

Elke

Blueleyla
Member

Re: Letrozole Side Effects

Hi angabb54 just seen your post. I have been on Letrozole since January, either Dr Reddys or Accord apart from a very brief spell on Cipla.  I felt dizzy all the time, went to my doctor who's lovely and told her I couldn't cope for the next 5 years on the Cipla brand.  She gave me another prescription to get some more and has put a note on my medical record.  Despite this I still get give given Cipla sometimes but I always check before I leave the pharmacy and if Cipla point out that my notes say not that brand. So far pharmacist has been fine and found another brand. We have to take this for a long time so you need to find a brand that agrees with you.

Carolyn52
Member

Re: Letrozole Side Effects

Hello Mary
Snap ..I'm on letrozole and been feeling so cold too ..have heating on etc. Normally in the summer I'm the Queen of flip flops ..wear them March to October but this year have lived in sketchers type shoes. I also have been wearing socks to bed ..even in summer. .what a wuss ?
In fact last night I was convinced I was starting a cold and took a lemsip at bedtime !! But nothing developed.
So you are not alone !! But it's a good treatment so we must persist. .even if our heating bills go sky high.
Xx
maryminder
Member

Re: Letrozole Side Effects

Hi Ladies

 

I have been back on Letrozole for about 3 weeks now following a 12 week break due to SE's, have found this time that by mid evening I get very very cold my hands and feet become like ice blocks, it's like the chills when you have a bad infection, can't stop shaking no matter how many clothes or covers I put on, this goes on for a couple of hours,  didn't have this before it was usual joint/muscle pain.

 

Has anyone else has experienced this and should I contact my Oncologist or BCN?

 

Best Wishes

Mary x

dancingpip
Member

Re: Letrozole Side Effects

Hi angabb54 - Have you run your pathology through the predict tool? http://www.predict.nhs.uk/predict_v2.0.html at least if you do that then you will be able to talk over the results with your consultant and more able to make an informed decision. When I found my predict results I decided to ask if I could be prescribed a lower dose of letrozole but the consultant actually agreed that I could stop taking them completely. Also - I understand that taking calcium (a bone density drug) is not good for the body unless it is combined with magnesium - it is probably worth doing some research on that before you meet your consultant too. All the best Pip
Happyboobs2
Member

Re: Letrozole Side Effects

Hi, I agree with you Carolyn...I don't feel too bad with Accord. I tried Cipla and Actavis.

I get my from Boots and tell them I only want Accord. So far they have been very good.

xx

Carolyn52
Member

Re: Letrozole Side Effects

Hello judi
I collected mine Friday from boots chemist but I have my prescription marked "accord only". Hope they don't discontinue them ...aagh.
I have heard that Dr reddy and teva are ok too as a option.
I think it's cost as maybe accord are a little more expensive. .a lot of pharmacists buy in bulk at the best price so unless you have your prescription marked ..they will fob u off with a cheaper option!

Hope you get it sorted ..it's miserable enough without all your extra side effects ..
Xxx
ollisj6
Member

Re: Letrozole Side Effects

Hi. Carolyn just read your post and don't think I've gone balmy but the last time I went to pick my letrozole up the pharmacist told me accord was no longer available and after this batch it would be actavis brand instead I did have a bit of a panic attack as the accord suits me and I had major joint pain before but that was cipla brand I suppose I won't know until I've tried are you still able to get accord thanks love Judi xxxxxxx

Carolyn52
Member

Re: Letrozole Side Effects

Hiya ...if you have been taking Cipra brand ..bin them they are terrible ..I had them twice and felt horrible on them . I insist on Accord brand monthly now and they are more easy to tolerate but I think the side effects accumulate over the time ..I have been nearly 2 years on them now but they are a powerful little pill ...
Yes bone strengtheners also cause more bone pain ..I have a monthly injection called denosumab ..which can give me a real back ache for a few days each time but needs must .
Definitely speak to your oncologist / breast care nurse as there a few other options which might suit you better .
Xx
angabb54
Member

Re: Letrozole Side Effects

Thank you so much Helena, so good to hear from someone.! Xx

ladybowler
Community Champion

Re: Letrozole Side Effects

angabb

 

Hello and welcome to the forum where you will get loads of help and support form the wonderful ladies on here.

 

I can not help with regard to letrozole, but I will say that when my oncologist realised that I had some osteoporosis in my lower spine he changed me from the original letrozole to tamoxifen.  I am post menopausal and tamoxifen for usually prescribed for pre manopausal ladies.  I am not taking any additional drugs for it at the moment as my GP said it was the low end of normal and there are life style things I can do to prevent it getting worse, exercise etc

 

You are right and I have read on here how different brands do produce different side effects, I believe it is something to do with the coatings because the main ingredients are supposed to be the same hichever brand.

 

I really hope that you get some answers and a resolution to your problems with letrozole so that your quality of life can be improved.

 

helena xx

angabb54
Member

Re: Letrozole Side Effects

Hi girls...this is my first post.

Decided to take the plunge and join in the chat. I had a mastectomy of left breast in Jan 2015 no chemo or radiation. I've been on Letrazole for over 2.5 years to mop up oestrogen as the tiny cancerous bit they found in my breast after removed it..was HER positive. I was was told it was for 5 years... side effects are vile , pain in joints, exhaustion, low libido and mood, extreme fatigue, sleeplessness, itching skin, anxiety, thinning hair, horrible headaches and eye disturbances and stomach pain. I was a fit 60 year old when diagnosed. Since this drug  I feel I've aged 30 years. My mum is 87 and is in less pain and distress than I am! However all said and done I felt I was getting on ok and dealing with the SE..( I do have a high pain threshold) This last two weeks have been MUCH worse and after reading some forums I am thinking it could be because I have been given the Cipla brand of Letrazole...last night I felt so poorly thought I might go to hostpital ...in bed now for the day, which has been necessary on and off for the past two weeks. Today I am not taking the tablet and intend seeing GP Monday to get an appointment with a consultant. This really is a powerful toxic drug.and at just 2.5 mg...what is going on? I also have been told I must take a bone density building drug as have a bit of osteoporosis in my back..tried this too and got joint pain big time as a side effect of this one!....Hoping to get some answers in the next few weeks, meanwhile, keep chins up fellow sufferers and will post soon. 

Angel62
Member

Re: Letrozole Side Effects

I'm like you exercisec and walk daily i find that realky helps me. I taje it st night too and I'm a littke warm first thing in the morning but seem fine the rest of the day. ALos drinks lots of hit water and lemon through the day. Been taking it 2 months so far x
Carolyn52
Member

Re: Letrozole Side Effects

I take vitamin c daily ( fizzy ones ) and cod liver oil tablets ..not sure but I do think that they both help.
Anniej
Community Champion

Re: rsRe: Letrozole Side Effects

Hi Suzi Ann, my homeopathic practitioner recommends dandelion tea and extract for getting rid of water. Haven't been bothered with that, so far. For my hot flushes I'm using sage tea and fresh sage in everything! Salads, soups, lasagne, sauces. You name it and in it goes ! I seem to be managing the Letrozole ok - so far, but just two months in. Perhaps the Glucosamine with Chondroitin and vit C is helping? I also attend TaiChi and yoga at Maggies which I swear is helping joints. 👍🏻

Carolyn52
Member

Re: Letrozole Side Effects

Hello Suze Anne
Phew ..as you are going to be on letrozole for the long haul ..you need to be comfy with the side effects ..
You would need to check out water tablets with your doc as with liver probs ..they might affect them. Hubby takes them for copd and they do help water retention. Natural things like lettuce and celery can help puffy feet and I find peppermint tea has the same effect !!
Don't suffer though as you do need quality of life .
Xx
suzi-ann
Member

Re: rsRe: Letrozole Side Effects

I also take 2.5 Mar-Letrozole and stopped drinking wine but my oncologist said I could drink Boost if you are familiar with it and that would be considered a dairy product indirectly.  I had a wee little cancer in my left breast near my underarm and had it removed along with 2 of 5 lympth nodes removed and kept my breast as i refused to have it removed not knowing exactly what they would find while I was under.  I had only one chemo treatment and thought my life was over because I suffered every side effect listed plus more but I did go for 25 radiation treatments.  Two years in remission and was told I would be taking letrozole forever.