Posts Tagged ‘resistance’

Arnold Kegel’s Device—The Perineometer: Prototype Resistance Device

July 23, 2016

Andrew Siegel MD 7/23/16


Image above: Arnold Kegel’s perineometer


The pelvic floor muscles and vagina often become traumatized with the process of pregnancy, labor and vaginal delivery.  Pelvic floor dysfunctions may result, including pelvic organ prolapse and vaginal laxity, stress urinary incontinence and sexual issues.

In the 1940s, Dr. Arnold Kegel created a special apparatus called a perineometer to help restore pelvic function and vaginal tone in women who had recently delivered babies.  The term is derived from perineum–the anatomical region between the vagina and anus (where many of the pelvic floor muscles are located) and  meter–to measure.  The device was placed in the vagina and provided resistance to contract the pelvic floor muscles upon and feedback as to pelvic floor muscle strength.

The perineometer is a pneumatic chamber about three inches in length and less than one inch in width. It is attached by tubing to a pressure measuring tool (similar to a blood pressure gadget) that is capable of measuring pressures ranging from 0-100 millimeters (mm). The patient inserted the device into her vagina and then contracted her pelvic muscles. The device provided resistance to clench down upon, similar to contracting one’s biceps against the resistance of the weight of a dumbbell as opposed to doing arm flexes with no weights. The perineometer allowed the user to observe the magnitude of each contraction of her pelvic muscles.

Who Knew? In terms of feedback, the perineometer device is not unlike the “ring the bell” strongman game at an amusement park where one swings a mallet as hard as they can in an effort to ring a bell mounted at the top.

The feedback element was of vital importance to the pelvic floor muscle training process, serving as a visual aid and confirming to the patient that the proper muscles were being contracted. It also served the purpose of showing day-to-day improvement, helping to encourage the participant to complete the program. Kegel recommended recording the maximal contraction at each exercise session, the written documentation providing further encouragement.

 Who Knew? Tracking one’s performance is fundamental to the success of pelvic training. By being able to observe forward progress over time, the process is enabled.

Kegel observed that when the vaginal muscles were well developed and had a contractile strength of 20 mm or more, sexual complaints were infrequent. However, when the vaginal muscles were inelastic, thin, poorly toned and had a weak contractile strength, sexual dissatisfaction was commonplace. Kegel observed that younger patients progressed more rapidly through pelvic training than older ones.

Who Knew? Patients vary greatly in their ability to contract their vaginal muscles. Some women are incapable of clenching down on an examining finger in the vagina, whereas others can squeeze so hard that the finger hurts!

Kegel recognized that pelvic muscle reconditioning proceeded in a sequence of stages. The initial phase was awareness and coordination. The next phase was transitional, the adaptive phase when the body learns how to properly execute the exercises; this was followed by regeneration, when the pelvic muscles respond to the exercises and increase their mass, strength, power and coordination. The final stage was restoration, in which there was a leveling out of the maximal pelvic muscle contractions.

Who Knew? Kegel observed that following restoration of pelvic floor muscle function in women with incontinence or pelvic laxity, many patients had increased sexual feelings—including more readily achieved and better quality orgasms.

Kegel’s PFMT regimen was rigorous, requiring a significant investment of time: 20 minutes three times daily for a total of 20-40 hours of progressive resistance exercise over a 20-60 day period. He emphasized the importance of not only pursuing pelvic training after pregnancy, but also prophylactically during pregnancy.

Bottom Line: In the 1940s, Dr. Arnold Kegel developed the prototype pelvic training device used to provide feedback to the user as well as create resistance to contract down upon. After many years of quiescence following Dr. Kegel’s seminal work, we have recently witnessed the availability of numerous resistance devices available in a rapidly changing, competitive and evolving market, all of which are based on Kegel’s perineometer. Most of the sophisticated training devices provide similar basic functionality—insertion into the vagina, connection to a smartphone app, and biofeedback and tracking—although each device has its own special features. An upcoming blog will review the current devices that are available. 

Wishing you the best of health,

2014-04-23 20:16:29

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:

Author of THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health– and MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health available on Amazon Kindle, Apple iBooks, B&N Nook and Kobo; paperback edition available at

Author page on Amazon:

Apple iBook:

Trailer for The Kegel Fix:  

Co-creator of Private Gym and PelvicRx: comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training programs. Built upon the foundational work of Dr. Kegel, these programs empower men to increase pelvic floor muscle strength, tone, power, and endurance: or Amazon.  In the works is the female PelvicRx pelvic floor muscle training DVD. 

Pelvic Rx can be obtained at, an online store home to quality urology products for men and women. Use promo code “UROLOGY10” at checkout for 10% discount. 




Antibiotics: Double-Edged Swords

April 9, 2016

Andrew Siegel MD  4/9/16

…A break from my typical “pelvic health” entries to briefly review these miraculous medications that are of both great benefit and detriment to humans and humankind. Beginning next week, I segue to the topic of “female pelvic health.”


The 19th century –the “century of hygiene”–was marked by improved public health and sanitation, which saved more lives than any other cause.   The 20th century–the “century of medicine”– witnessed the development of antibiotics, vaccines, medications, chemotherapy, etc.  The 21st century could aptly be labeled the “century of resistance,” as overuse/misuse/abuse of antibiotics has resulted in the emergence of highly resistant “superbugs” that are one of the world’s most pressing public health problems. 

Ten Indisputable Facts Regarding Antibiotics

  1. Antibiotics are indispensable assets and essential weapons in the fight against bacterial pathogens, in many cases proving lifesaving.
  2. Antibiotics have dramatically improved human quality and quantity of life.
  3. Antibiotics arguably are the medication class that has been most abused, overused and/or used inappropriately (although pain medications are right up there as well).
  4. When prescribed for non-bacterial infections, e.g., the common cold and other viral upper respiratory infections, antibiotics not only provide absolutely no benefit, but also can be detrimental.
  5. Antibiotics can induce allergic reactions and many other side effects including tendon weakness and rupture associated with the use of Ciprofloxacin and other members of its class.
  6. Antibiotics destroy healthy bacteria along with pathogenic bacteria, causing adverse effects due to the change in the population of the bacterial ecosystem: yeast infections; infection/inflammation of the colon (colitis) caused by overgrowth of Clostridium difficile; and the selection of “superbugs” that are resistant to antibiotic treatment.
  7. Antibiotic overuse in farm animals–the number one consumer of antibiotics– has contributed in a major way to the surge in these “superbugs.”  Resistance is of particular concern in children because they have the highest demand for antibiotic use and fewer choices since some antibiotics cannot be safely used in children.
  8. On an annual basis 2,000,000 Americans acquire antibiotic-resistant infections;            23,000 die from them.
  9. 50% of outpatient antibiotic prescriptions in the USA are considered unnecessary.
  10. Antibiotics are often prescribed inappropriately because patients “demand” them and the “path of least resistance” is often for physicians to prescribe them.

Bottom Line:  Antibiotics are a powerful component of the medical armamentarium against disease, but are double-edged swords that must be used judiciously and appropriately.  (So the next time a patient with a cold asks me to prescribe a Z-Pak, you know what the answer will be!)

Wishing you the best of health,

2014-04-23 20:16:29

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:

Author of The Kegel Fix: Recharging Female Pelvic, Sexual and Urinary Health– available on Amazon Kindle as of today:

Trailer for The Kegel Fix

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: 

Co-creator of Private Gym and PelvicRx: comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training programs. Built upon the foundational work of Dr. Arnold Kegel, these programs empower men to increase pelvic floor muscle strength, tone, power, and endurance: or Amazon.  In the works is the female PelvicRx.

Pelvic Rx can be obtained at, an online store that is home to quality urology products for men and women.  Don’t forget to use code UROLOGY10 at checkout for 10% discount. 

Kegel Exercises: GET WITH THE PROGRAM!

October 11, 2014

Andrew Siegel, M.D.

The problem with most D.I.Y. (Do It Yourself) pelvic floor exercise regimens is the same issue with any activity done without proper guidance—compliance—sticking with the plan and seeing it through long enough to reap meaningful results. In order to D.I.Y., you need some real sitzfleisch (my new favorite word)—literally “sit on your flesh”—staying power and perseverance. And if your program ain’t working, your sitzfleisch is going to rapidly peter out.

One of the greatest challenges is that there have been no well-designed, easy-to-follow pelvic muscle training programs. Being handed a pamphlet suggesting a several-month program of 10 Kegel muscle contractions squeezing against no resistance three times daily during down times—for example while stopped at a red light in your car—simply does not pass muster! These inadequate programs lack guidance, training, direction and the feedback to confirm the engagement of the proper muscles. It is not surprising that if you undertake one of these ineffective pelvic floor muscle exercise regimens, you will more than likely ultimately abandon them.

The bottom line is that you will be unlikely to commit to an ineffective regimen, and any regimen will be ineffective unless it is a well-designed program that adheres to the tenets promoted by Arnold Kegel, the namesake of pelvic floor muscle training. Kegel’s principles that are imperative to adhere to are the following: muscle education, biofeedback, progressive intensity and resistance.

Muscle education is an understanding of your pelvic floor muscle anatomy and function and precisely where in your body that these muscles are located. This will permit you to develop muscle memory—the development of the nerve pathway from your brain to your pelvic floor muscles, a.k.a. neuromuscular education in medical lingo.

Feedback is a means of confirming to you that the proper muscles are being exercised, important since studies have shown that over 70% of women who think they are doing pelvic floor muscle exercises properly are actually squeezing other muscles, typically the rectus (abs), gluteal (butt) and adductor (thigh) muscles. With respect to the male gender, most men have not a clue as to where their pelvic floor muscles are, but also what their pelvic floor muscles do, how to exercise them, and what benefits they confer. In fact, many men don’t even know that they have pelvic floor muscles.

Progressive intensity is an escalation of the exercise magnitude and degree of difficulty over time. In a graduated fashion, you increase repetition number, intensity of contraction and duration of contraction. This progression is the key to increasing your pelvic floor muscle strength and endurance. Additionally, it allows you to measure and monitor you progress by witnessing your increased capabilities over time.

Resistance adds a new dimension that further challenges the growth of your pelvic floor muscles. Working your pelvic muscles against resistance rapidly escalates their strength and endurance, since muscle growth occurs in direct proportion to the demands and resistances placed upon them, a basic principle of muscle physiology.

Dr. Kegel recognized that the process of pelvic floor muscle strengthening advances in phases starting with awareness of the pelvic muscles and slowly and progressively proceeding to muscle regeneration and ultimately restoration.

As a physician, I see many female patients who have tried Kegel exercises and report that they did not help the problem they were trying to improve. However, on examining them and testing the strength and integrity of their pelvic floor muscles, they are often found to be contracting the wrong muscles! On questioning them on their regimen they often relate that their gynecologist had at some time given them a single page handout detailing how to perform Kegel exercises.

NO, NO, NO!…this simply will not do. One needs to GET WITH THE PROGRAM and receive the proper training to make these exercises meaningful and purposeful. The vast majority of those who try Kegels do not use a program that provides the precise wherewithal to isolate and exercise the pelvic floor muscles in a progressively more challenging fashion. It’s the equivalent of giving someone a set of weights and expecting them to pursue a weight training regimen without giving them the exercise routine and supervision to go along with the hardware, dooming them to failure!

For pelvic floor muscle strengthening to be effective, it is critical to use a well-crafted, progressive instructional routine with the ultimate incorporation of a resistance device. This is now available for men with the release of the Private Gym ( for men, and the program for women is in the works.  Do it right or don’t do it… In order to do it right, you need to get with the program!


Wishing you the best of health,

2014-04-23 20:16:29

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health:

Private Gym:


Kegel and the Game “Telephone”

September 27, 2014

Andrew Siegel, M.D.

When I was in junior high school (yes, junior high…no such thing as middle school back in those dark ages!) we had parties and played silly games such as “spin the bottle” and “telephone.” In both games a group of us would sit in a circle, and with respect to the more sedate “telephone,” the first person would whisper a few sentences into the ear of the person sitting next to him or her. That person would repeat it to the next person, and so on around the circle. The last person would announce the message they heard. The message that the final person announced was virtually always very different and distorted from the original message, usually in a very funny way. My point is that the final “product” bore little, if any, relationship to the original, with each step in the communication process resulting in increasing adulteration.

And so it is with the exercise program that gynecologist Arnold Kegel popularized 65 years ago, with which the game “telephone” has seemingly been played. What is being bandied about now as Kegel exercises bears little to no resemblance of what Arnold Kegel described so brilliantly in his series of medical articles. As a consequence of this adulteration, current Kegels are often ineffective Kegels. Arnold Kegel died in 1981; if he were alive today to see the distortion and misinterpretation of his legacy, I am certain he would be unpleased.

I have carefully studied all of the medical journal articles that Arnold Kegel crafted in the late 1940s. In these scientific works, he explained his program of pelvic floor exercise that he used successfully on thousands of his female patients. I will happily provide PDF copies of Kegel’s articles to any reader interested in the classic, original, unadulterated works. I have distilled Kegel’s message to the following four principles:

  1. Muscle education with the development of the nerve pathway from brain to pelvic floor muscles.
  2. Feedback to confirm to the exerciser that the proper muscles are being used.
  3. Resistance that challenges the exerciser.
  4. Progressive intensity against resistance so that the exerciser can measure and monitor progress over time as pelvic floor muscle strength increases.

So, in accordance with the seminal work of Arnold Kegel, pelvic floor exercises should incorporate muscle education, biofeedback, resistance, and progressive intensity. Kegel recognized four phases of the process of pelvic floor muscle strengthening: “awareness, transitional, regeneration, and restoration.”

Now here is the problem—if you Google search “Kegel exercises” you will get over one million results, but virtually every exercise “program” that you read about—even those publicized by esteemed medical institutions—are knockoffs and meager dilutions of the rigorous resistive pelvic floor exercise regimen advocated by Arnold Kegel. These current programs require very little time, limited physical effort and most often lack in using the benefit of resistance.

Your search will often uncover a printable pamphlet suggesting a several month program of 10 contractions squeezing against no resistance to be done three times daily while stopped at a red light when driving your car or at other down times. What these current programs share in common is that guidance, training and direction are inadequate with programs lacking the feedback to confirm the engagement of the proper muscles. It is of no surprise that many who undertake these ineffective, bastardized pelvic floor muscle exercises ultimately abandon them as they fail to help the situation at hand. The recommendation of doing these exercises while multitasking is a recipe for certain failure. Properly executed pelvic floor exercises—like physical therapy—demands attention, focus and gravitas.

Exercise physiology has taught us that when it comes to muscle training, doing lots of sets with low resistance develops tone and definition, whereas doing fewer sets with maximum resistance builds strength and bulk. The same physiology can be applied to the hidden pelvic floor muscles. A successful exercise program mandates intensity to be successful as muscle adaptation will not occur unless the muscle is subjected to sufficient stresses and resistance.

Kegel devised the “perineometer,” a resistance device that enabled women to work out their pelvic floor muscles against the force of resistance. This device gave visual biofeedback regarding the engagement of the proper muscles and the actual strength of those muscles and allowed women to witness the gradual increase in the strength of their pelvic floor muscles. In terms of intensity, Kegel’s recommendation was “twenty minutes of exercise three times daily, with a total of at least 20-40 hours of progressive resistance exercises spread over 20-60 days, keeping records of maximum contractions each exercise period.” This is a far cry from any of the current programs that you will come across! Additionally, most exercise programs do not utilize a tool that parallels the essential role played by Kegel’s perineometer.

So many of the mainstream programs out there do not hold muster and are terribly ineffective. There is an enormous demand for effective pelvic floor muscle training programs, and the number of people who could potentially benefit from an effective program that adheres to the successful foundational principles laid down by Arnold Kegel is huge. So what to do?

And thus was born the concept of the Private Gym pelvic floor training program, developed through the collaborative efforts of an international team of experts including myself. The Private Gym’s Basic Training program strengthens the pelvic floor muscles with a series of progressive male Kegel exercises without resistance. The Resistance Program uses resistance equipment to maximize pelvic floor muscle strengthening. This program completely adheres to the foundational principles of Arnold Kegel, and then some. The Private Gym program incorporates muscle education, biofeedback, progressive intensity, and resistance. The new dimension added is progressive resistance, so that as pelvic floor muscle strength increases, the trainee can increase resistance accordingly. In other words, as your pelvic muscles get stronger, they can be challenged with increasing resistance. With Kegel’s perineometer, women worked out against the same resistance and over time were able to generate stronger contractions, but with the Private Gym resistance device, you not only develop strength by making progress against resistance, but ultimately increase the resistance in order to optimize the strength of the pelvic floor muscles.



And don’t worry ladies, our Private Gym for women program is in the works.

Wishing you the best of health,

2014-04-23 20:16:29

Andrew Siegel, M.D.

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:

Note: As Arnold Kegel popularized pelvic floor muscle exercises in females in the late 1940’s, so I am working towards the goal of popularizing pelvic floor muscle exercises in males. This year I published a review article in the Gold Journal of Urology entitled Pelvic Floor Muscle Training in Men: Practical Applications to disseminate the importance and applications of these exercises to my urology colleagues. I wrote Male Pelvic Fitness: Optimizing Sexual and Urinary Health, a book intended to educate the non-medical population. Finally and most importantly, I, along with my partner David Mandell and our superb pelvic floor team, co-created the Private Gym male pelvic floor exercise DVD and resistance program.

For more info on the book:

For more info on the Private Gym:




















Use It Or Lose It: The Wow of Human Plasticity and Adaptation

May 30, 2014

Blog # 156

Think for a momentabout orthodontics. Braces are applied to one’s imperfect teeth and ever so gradual increasing resistance is implemented over time and, presto, in a couple of years, the teeth are perfectly straight and beautiful.

Exposing our bodies to the right “environment” on a long-term basis can positively affect not only our external appearance, but also more importantly, our internal health. Conversely, exposing our bodies to the wrong environment on a long-term basis can negatively affect our external appearance and internal health.

Essentially, the cells and tissues of our bodies—including our muscles, bones, brains, and every other organ—are endowed with a remarkable capacity for “plasticity,” the quality of being able to be shaped and molded in an adaptive response to environmental changes. What it comes down to is that our human body is an adaptation machine.

Our composition is “fluid” as opposed to “static,” and our tissues are constantly being remodeled, restructured and refashioned in adaptive responses occurring in accordance to the forces, stresses, resistances and demands placed upon them. This plasticity is an amazing phenomenon and permits our tissues to maintain normal function when burdened with adverse “resistances.” Conversely, we can tap into this powerful resource by purposely challenging our tissues with the appropriate resistances to enable them to perform at extreme high levels of function.

An example of our bodies’ attempt to maintain normal function when burdened with adverse resistances is benign enlargement of the prostate gland.  Almost inevitably, all aging males experience this gradual growth of this curious gland wrapped around our urethral channels. As a result of this “crimp” on the urethra, the resistance to the flow of urine gradually increases. However, the bladder muscle adapts by hypertrophying (getting more muscular). The bladder ever so slowly changes from a thin and smooth muscle to a thick and rough muscle in order to generate the higher pressures necessary to enable getting the urine out through the impeded urethral passageway. The unsuspecting individual with this condition may experience no symptoms for quite some time because of this natural compensation. However, compensation cannot occur indefinitely as there are natural limits on this plasticity, so one day he may be unable to urinate because the bladder hypertrophy has become maxed out, yet the prostate growth and increased resistance continues relentlessly, resulting in a condition known as acute urinary retention.

Another example of our bodies’ attempt to maintain normal function when burdened with adverse resistances is hypertension, which totally parallels the situation with the prostate and the bladder. High blood pressure creates an environmental situation for the heart in which it needs to work harder to pump blood because of the increased resistance created within the walls of the arteries. Consequently, the muscle fibers of the heart hypertrophy, resulting in a larger and more muscular and powerful heart that can continue to pump blood effectively through the resistance of the high arterial pressure. The problem is that the “compensated” heart is subject to problems such as angina, arrhythmias and heart failure, and can get to the point—similar to the urinary bladder—where it decompensates and fails. Exercising the heart is desirable, but this is not the kind of exercise you want your heart to have

The powerful resource of plasticity and adaptability can positively and purposely be tapped into by challenging our tissues to adapt to the appropriate environmental changes (resistances) to enable our tissues to perform at extreme high levels of function. One type of resistance that is most beneficial is exercise.

Exercise is all about adaptation. The SAID principle (Specific Adaptation to Imposed Demands) posits that our body will adapt—in neuromuscular, mechanically, and metabolic terms—to the specific demands that are placed on it. This is the very reason why both endurance and resistance exercises get easier the more effort we put into doing them. Asthe body is subjected to gradual and progressive “overloads,” the heart, lungs and muscles adapt and a “new normal” level of fitness is achieved. It comes down to the fact that our muscles are plastic and capable of hypertrophy (growth) or atrophy (shrinkage) depending on the environment to which they are exposed.

I enjoy recreational cycling, but to date this season have not spent as much time in the saddle as I would have liked. I’ve been out for a number of 20-mile rides but last weekend went out with a friend for a hilly 50 miles. The last 10 miles were extremely difficult, as my body had not yet adapted to that kind of challenge; clearly I don’t have my cycling “legs” back yet. My heart and lungs were not the issue, but my glutes and quads were not up to the beating and challenge…but they will be in due time. Just as the marathon runner who gradually builds up to running the distance, so it is with every endurance sport

Adaptation to exercise is applicable to all aspects of fitness: cardiovascular or aerobic fitness in which the heart and lungs adapt to endurance efforts; musculo-skeletal fitness in which our muscles and underlying bony framework adapt to bearing loads and working against resistance, leaving our muscles sinewy, strong and toned; core strength, which is fitness of our torso muscles that allows us to maintain good posture, stability, balance and coordination as well as serving as a platform for efficient use of our arms and legs; and flexibility fitness in which our muscles are elastic, limber, supple and more resistant to injury.

Our bodies demand physical activity in order to function optimally. For example, our bones require weight bearing and biomechanical stresses in order to stay well mineralized and in peak functional condition, as bone mineralization is stimulated by the stresses brought on by a variety of movements. The same holds true for every organ in our body to maintain maximal functioning—they need to be employed and put into the service for which they were designed

“Use it or lose it.” As much as our bodies adapt positively to resistance, so they will adapt negatively to a lack of resistance. For example, after wearing a cast on one’s arm for 6 weeks, there is noticeable wasting of the arm muscles, known as “disuse atrophy.” Contrast this with the opposite scenario—exercising one’s arms by doing curls on a regular basis—which will result in an obvious hypertrophy of the arm muscles. When our bodies are sedentary—for example on the basis of a severe injury requiring bed rest—there is a rapid demineralization and thinning of our bones. Spinal cord injured patients who are paralyzed undergo just such a rapid demineralization. Astronauts who spend time in zero gravity (which takes all biomechanical forces away from the bones) experience a remarkably fast demineralization and risk not only thin bones—as does anybody with rapid demineralization— but also of developing kidney stones from the calcium mobilized from the bones. The process of adaptation is not limited to our muscles and bones, but involves each and every internal organ, including the kidneys, liver, pancreas, brain, etc. That is why it is so important to expose our bodies to positive “resistances” and not to “negative” resistances.

Our central nervous system is constantly being remodeled in response to environmental exposure. The brain’s neurons undergo anatomical changes and reorganization of their networks with new neural connections in response to new situations or environmental changes (learning). Through the processes of “neuroplasticity” and adaptation, learned behaviors actually modify the electrical hardwiring of the brain, which is dynamic and constantly subject to revision. Synaptic “sculpting” facilitates learning and synaptic “pruning” occurs when patterns are not repeated. Thus is explained on a biological basis how learning occurs.

Bottom line: Humans are bestowed with an amazing and magical capacity for plasticity and adaptation, which can be transformative when used to our advantage and benefit. Expose our bodies to positive cognitive and physical nourishment and they will be carved into beautiful, highly functioning machines. Expose our bodies to negative forces or absence of positive forces and they will falter into ugly, poorly functioning, maladaptive machines.


Andrew Siegel, MD

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health; available in e-book (Kindle, iBooks, Nook) and coming soon in paperback.


A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”: