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Old 12-15-2008, 10:24 PM   #1
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Help needed to understand what is going on

My husband and I are trying to understand what is going on with his 88yr. old mother. Her overall health is astoundingly good. She has had no sudden change in mental/emotional abilities but over the last 15 yrs. she has had a steady slide into something that we cannot understand. She never was a warm person but her affect has become increasingly flat. She seems to have lost any ability to be empathetic or caring for others.She was always sort of close minded and rigid but she has become sort of mechanical with very repetitous ways of communicating. She writes us a letter 1-2 times a week-each letter is almost a carbon copy of the last. In fact, you could read a letter from 5 yrs. ago and it too is the same. Her behaviors seem ritualized.
Her letters start with her weather in Oklahoma, ask about our weather in Wa. and then discuss the weather her other son is experiencing in Canada. That takes up 3/4 of the letter. Then there is added on some little bit of repetition about her cremation is paid for, she does not want to be buried (that is in caps). Maybe a little about a sister in law she talks to.About 4 times a year she does a personal narrative history letter-when she met her husband, their courtship, their marriage, his stint in the army, birth of the kids, the dates are generally pretty screwed up--but the language from narrative letters is always the same. And this has been going on for years.The personal narrative has no emotional content-it is just like a factual cold obituary.
Her weekly phone conversations are EXACTLY the same as the letters.The weather is nearly the total focus.It is like she has a script for the conversation.
She is pretty terrible with recalling names. Getting peoples names confused.
At 88 with grey hair, she says it is amazing that her hair is still blonde and hasn't gone grey.She even says people comment on this.
She is seemingly incapable of feeling anything--when I was ill and hair falling out due to meds she abruptly said"get a wig", when our dog of 15yrs. died-no sympathy. And, about her deceased husband (he died about 5 yrs. ago) nary a word. While she was sad about his death, she barely said anything about him and never reminisced except the personal narrative letter that is written as I said like an obituary.
If you contradict her to correct something which we would only do on rare occassions to correct a misperception-like she thought the rental property payments she received were once yearly and we said no they are twice a yr. It made her ******, cranky .This has happened several times.She doesn't want to inquire about anything just "she knows what she knows and that is it" period.
On the plus side, while she lives in her own apt. in a sr. facility-she seems to do ok. Her apartment is very tidy and she manages to get some groceries-a bus takes them to the store. And 2 meals she eats in the cafeteria ea. day.
We are wondering about flat affect, and highly ritualized/mechanical/rote behavior and modes of communication.
As there was no sudden onset of this-we are not suspecting a mini-stroke. To those who know, does this sound like early Alzheimer's or dementia? We wonder what this is and how it will progress.

 
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Old 12-15-2008, 10:54 PM   #2
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Re: Help needed to understand what is going on

yup, it sounds very familiar. there is no emotion in her letters and she talks about the weather because her emotions are becoming limited and her depth of conversation is limited to the very obvious. Anything more in depth might let this disease leak out. make sure that someone is responsible for her daily dealings - money/cheques/bills. it is very common at this stage to start getting confused in these areas. and yes, denial is a very common side effect. how slowly or quickly the disease progresses is anyone's guuess but i strongly suggest you get her to the doctor for a diagnosis. From there you can arrange for ALZ drugs, POA(power of attorney) for whomever will be in charge, etc. It's a long road, best of luck..

 
Old 12-15-2008, 11:01 PM   #3
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Re: Help needed to understand what is going on

This is my Best Guess

First Off, probably more dementia, just lose of short term memory 1-3 days, 1-3 months.

I say, this because fwiw, she seems too process information okay, based on her actions.

Alzheimer, in simple terms is lose of memory, plus inability too process information based on where the brain is now.

Dementia, forgets a phone number used for years, is frustrated about it, yet, knows okay i can get it from phone book if i want.

Alz, forgets phone number, doesn't have a recolection why phone number was ever important, and would not think, aha, phone book has the number. Five minutes from now, would not remember there was ever a phone number issue on the board.

I re-read your post 4-5 times...............imho, one of the toughies is that personality wise she was always rigid in actions, ie, she did was she liked, and none of what she didn't...................over time with aging, there is a limit of what can be done, more due too physical limitations, than desires.

She probably was never the type to sit around and have several hour long conversations on emotions, or even spend a half an hour expressing how she feels about something in depth.

Thus, you are picking up on body language and tone of voice, and thinking, if we used a picture on a TV screen analogy..............the picture is there, we can watch, sound is okay, yet, u know if you fiddled with adjustments picture could be a tad better.

She may have a bit of depression, which is just a lack of joy in your life, which would check off the two main points u bring up, her affect and empathy. When u yourself can't feel it is hard, and if it has been years, it is harder.

So, possible low serotonin levels, or low testosterone levels, yes, women have the also.

Natural supplements u could try with no harm would be kava kava, st johns wort, or dhea.

hoped that helped
good luck

 
Old 12-15-2008, 11:19 PM   #4
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Re: Help needed to understand what is going on

It does sound like it could be the beginning of dementia. I agree that you need to check on her financies and make sure everything is being paid as it should be and there is no money missing. Check with someone close to her and see if there are any other strange behaviors.

Money seems to be a major issue. Either bills are not paid, paid repeatedly, money is lost or hidden or disappears. Math abilities decline. Can she count by 5's or 10's? Does she know the date and year? Repetition is common. You will hear the same stories over and over... sometimes in the same phone call. Check to see if she is buying the same things each time she goes to the store. Is she cooking for herself at all? Does she remember how to use electronic equipment? Does she take her medication as prescribed? I assume she is not driving. Not knowing her hair is gray and thinking it is still blonde is also typical. The lack of emotion is another key. They become very self centered and KNOW they are right.

It is a good idea to get her to a geriatric doctor and at least have him give her the Mini Mental Exam. If she is in a senior apartment with meals provided and is not driving she might maintain for a while as long as medication is not involved or there is someone that can give her the medication. If it is dementia then the familiarity she has with her surroundings is enabling her to do what she is doing. Does she ever visit with family members away from the senior home? How is her behavior when she is not in her apartment?

If you do not already have it you need to make sure somebody has a durable power of attorney for her, medical directive or medical power of attorney, and another other documents your state may require so that you can conduct her business when she is unable. It is also a good idea to have somebody else's name on all accounts. Without the medical POA she will need to add you, or somebody, to her HIPPA form at the doctor's office so you can talk to her physician. Do this now before it gets any worse. It will make life a lot easier in the long run.

Your best bet is to have your Mom checked by her physician, talk to her friends and neighbors, and see if you can find out what is truly going on. Dementia loved ones can be experts at hidding their illness. It is intentional at first but then become routine.

Welcome to the board. I hate this is going on with your Mom and you needed to come here but I do hope you find an answer to your questions.

Love, deb

 
Old 12-15-2008, 11:28 PM   #5
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Re: Help needed to understand what is going on

Upatnite-Thank you for a speedy response. So-is it toward Alz that you think the
-flat affect and
-very repetitious behavior
-name difficulties
points to?
My husband and his brother do have power of atty, and mostly my husband deals with her finances-so those things are mostly in place. But, she wants to be looped in and the rent checks go directly to her for deposit. Maybe soon that should change--but such a change now would probably make her go ballistic.
I see no way we could get her to a dr. for this now. Does it sound more like ALZ or senile dementia or ordinary aging to you?
And, if it were ALZ-do the drugs really help?

 
Old 12-15-2008, 11:41 PM   #6
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Re: Help needed to understand what is going on

The only way to know for sure Osteo is to have her assessed by a geriatric neurologist or other physician capable of making that determination along with a complete physical. My Dad was misdiagnosed by his GP with ALZ for years when he actually has Vascular Dementia. I had Mom diagnosed at a Memory Assessment Research Service that was part of our local university psychology department. According to them the earlier you start them on medication the better it works. It does not stop the disease at any point but only slows the progress of the disease. It works better for some than others and there are side effects to consider.

I don't think it is ordinary aging. Dementia is dementia but comes in different forms... the result is the same with some differences along the way. I still say it would be worth the effort to have her checked out. That is the only way you are going to know for sure.

Except for the fact that Mom did some strange things with money, like give $250,000 to some B rated insurance guys she met in a restaurant, and started complaining that she was depressed from being Dad's caregiver (he's truly not that difficult) there was not much that we noticed for a while. Then Dad ended up in the hospital from an overdose that Mom gave him and she told everybody he had a heart attack. When we looked back... WOW It all fell into place. That is when she was diagnosed. The year after, when we tried to keep them at home but were paying attention was the worst. Once we were clued in we realized jsut how bad she was and that they could not stay alone.

For you own peace of mind she really does needs to be assessed....

Love, deb

 
Old 12-16-2008, 12:07 AM   #7
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Re: Help needed to understand what is going on

css-1
Thank you too--you guys are great on this board!!! Ok I hear what you are saying about leaning more towards dementia, by those examples which you gave.Those examples helped me to understand much more and reminded me of some things I have seen on TV.
So, I will ask you too---is this senile dementia or would this more be just normal aging?
For sure she never was one to emote or process deeply. Even my husband who was her favored son says he never had an in depth conversation with her ever...
So you could say she is just going on with her non emotive approach to life but there is that rigidity and repetition about conversations and her letters .
Yes, the picture would look ok on the tv. She gets up and does what she needs to do. She puts her clothing on ok and is clean and presentable. She can go places.
New info coming at her and she goes all fuzzy, it seems she doesn't even want to try to process info.Or, she sometimes will wildly distort what it is and then cling to that perception and as I said get really mad if you tell her it is another way. We walk on eggshells with her.
Depressed--don't think so . She seems content in her cozy apt. She has a few acquaintances that she relates to. She certainly doesn't say she is depressed or sad--just the weather seems to be what she actually wants to talk about. If she were more together, I would say, she is talking about weather all the time to avoid talking about her emotional life because she is sooo unhappy. But, her general health and her sticking to her routines-these point to not depressed . Maybe she avoided her emotional life for so long that her blankness is what she wants-some insulation from unwanted surprises??
You are also right in that some of her general aging conditions like impaired hearing and sight from cataracts (she just had surgery) contribute to her confusion at times.She refuses to wear her hearing aid.
As to our suggesting that she take any supplements-first she won't process the information that we want to share with her, and she will feel we are telling her what to do and she won't do it. It sounds antagonistic I know and to me makes no sense as she truly loves my husband and is always saying that she was closest to him.Yes, I am aware about testosterone--I am 56 and on hrt and thinking of testosterone myself.
So we seem to be just stuck with things being how they are and when she gets much worse if that happens THEN we can take her to a doc. But, she wouldn't allow us to tell her to go to a doc about this now.
Is this just fairly typical -no cooperation or trying to make things easier?

 
Old 12-16-2008, 12:59 AM   #8
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Re: Help needed to understand what is going on

Deb-I feel like I struck it rich with all the help that you kind, dear people have offered tonight. I am so thankful to you folks for responding. I realize now that it has worn so heavily on us for the past 5 years or so.
Can she count by 5s or 10s-she wouldn't even respond to this if we asked. She would say she didn't want to do this-period.The date and year--well her letters sometimes have very incorrect dates. Also she recounts things differently-says her mom died at 100-when it was 92. Writes in her personal history narrative that her older son was born years later than actual year. So yes, numbers really are tripping her up--as well as summoning up names. But, she doesn't know this. Yes, same things said over in the phone call. And she is certain that she is right -especially when she is wrong. You seem to be very familiar with her behavior. And, from what you have said--you seem to be leaning toward dementia as my mother in law's condition.
No she doesn't drive--so we do not have that battle. That would be a battle that we would have to fight-but luckily it is a non issue.
Yes, of course the best thing would be to get her to competent medical help to analyze what is happening. She lives in a rural area of Oklahoma quite a distance from specialized medical care. I am doubtful that a local dr. could really help her. My father in law who was without a doubt suffering from dementia and several small strokes-he lost touch with reality and they put him in a general psych ward and had him going to group on a daily basis with all these younger people with garden variety psych issues. It was really not appropriate . We tried everything we could to help. My husband made so many emergency trips out to help him as did his brother. I know this must have traumatized his wife and likely pushed her deeper into her not wanting to feel things.
Right now we will get no agreement from her to be checked out -she will not do it period. Even if we were to say this could help you to be clearer for longer it would make no difference. We cannot even tell her she has some issues cropping up with names, numbers etc.
Your recounting of what happened with your parents was eye opening. Only time will tell where this is all going. Unfortunately for now we cannot get her any help because she will not cooperate. I think though that my husband should talk to her general physician and have them do some diagnostics.The physician should ask her to do the number thing and ask about what day /date it is. And, shouldn't that be routine anyway??
I am going to sign off for the night. It is very late. Perhaps upatnite will still be on but I have to get some shut eye.
Thanks again Deb-nice to meet you. Your experiences and insights were very helpful to me .

 
Old 12-16-2008, 05:40 AM   #9
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Re: Help needed to understand what is going on

Hi. My mother went through all this starting around 10 years ago, and died last year after Christmas, aged 99.

The repetitious letters and phonecalls are a grand attempt to fool everyone into thinking she is fine. The confused dates give her away.

As long as she is repeating something she said or wrote before, and has practically memorized, there is little chance of her making a glaring error that would alert the family.

Yes, people in early stages of dementia make efforts to hide it from the world. These efforts go as far as to say, "I never said that!" "I didn't lose it, someone came and took it." "I did tell you, you forgot!" etc.

Drugs in my opinion do not help in old age. Mom only got bad side effects from Namenda and Alricept. However, I hear of cases where they do help.

Everything else has to be ruled out before Dementia is diagnosed, including mini strokes, brain tumors or aneurisms, heart trouble causing poor circulation, urinary infections which oddly cause memory loss and confusion in the elderly, etc. This is reason enough to have a good thorough check up.

If it turns out to be Dementia, she will not be able to live alone since very bizarre and weird things happen - going out at night leaving the door unlocked, in winter with no coat, just one example from Mom's life. Throwing out brand new just bought food. Keeping scraps of food in bedroom drawers. Having delusions about neighbors friends and family, from 'they never come to see me" (they were there yesterday) to "she took all my money" (actually she gave it all to a scam artist) ..

Your Mom needs protection, care and understanding. Not 'correction." The brain stops recording new memories, so all explanations are immediately forgotten.

Good luck!

Martha

 
Old 12-16-2008, 07:51 AM   #10
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Re: Help needed to understand what is going on

Osteo, great to meet you as well. I hate that you need to be here but glad you found us. This is a wonderful group and saved my sanity when it was necessary to move Mom and Dad to AL.

My Mom NEVER agreed to be tested because she thought something was wrong. She went with me to "shut me up and prove me wrong!" In her mind, there was absolutely nothing wrong with her. She stomped into the testing session, which lasted most of the day, with her usual stubborn determination. She walked out completely confused, complaining that those people didn't have a clue what they were doing. When we received the report, even I was shocked by how sever it was. I knew it was bad but never THAT bad. The distance, Mom's intellegence and determination, and a wish for denial on my part combined to cloud the reality. She never agreed with the report, and once she lost it any idea that she might have ALZ was forgotten. To this day she swears there is nothing wrong with her. Right now she thinks that the fog in her head is created by "that place" she is living in and if we would let her go home she would be ok. I tell you this so you will realize that Mom is NOT going to agree that she has problems. In her mind she is fine..... it is the rest of the world that has gone crazy. She will never agree to a move because it's unnecessary. She is perfectly fine. At some point the family has to become the responsible party and realize that she cannot make sound decisions for herself.

You Mom doesn't want to count by 5's probably because she can't. Mom does that all the time. Her inabilities are either the result of somebody else, or the fact that she just doesn't want to do it. The Mini Mental test should be a standard at physicals but the truth is that it is not always so. Your hubby should talk to the doctor about this so the doctor will be aware of what is really going on. My Mom had her doctor, who was new, convinced that she was FINE. Her old doctor, she convinced it was just depression from caring for Dad. When he clued in she left him. Besides, he was getting old and wasn't "with it" any more.

We didn't have Mom diagnosed in the little town she lived in. I took her to a neighboring town that had the appropriate facilities for a proper diagnosis. Once you know what you are dealing with you can insist on proper treatment. ALZ will not respond to "talk therapy" because they don't remember what they have heard or scew it to fit their purpose. We also went that round. Mom's well meaning but uninformed therapist resulted in Mom sending us all packing in a fit of determined anger.... because she would be just fine if we were not interfering in her life. I put a stop to that.... and any further appointments. Don't give up on resources. There is something out there that will help. You might want to contact the local ALZ Association where she is to find out what is available.

I would check with her doctor then tell her that she needs a good physical. Tell the doctor you want a Mini Mental Test to be included. There is no reason to mention her cognitive status to her. That just brings about resentment and stubbornness on her part. Let the doctor see what he finds and go from there.

Good luck.... this is no fun to deal with and there seems to be road blocks at every turn but you can navigate around them. Been there done that

Love, deb

 
Old 12-16-2008, 10:13 AM   #11
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Re: Help needed to understand what is going on

Welcome osteo, my mom is your mom-in-law. She was always very self-centered and shallow, so it took me a while to notice that she no longer talked about anything other than her health and the weather (with a side-helping of how the weather affects her health). I think what tipped me off to a problem is what someone here suggested when I complained of her lack of empathy. They asked me if she was always mean, and of course she was not, self-centered but polite and generally kind. Last fall she wanted my husband to help her with something but he was with his dying mom. She called me up and asked "Is Rose dead yet?" I said no, and that Don had spent the night in the hospital sleeping sitting up on a portable cooler. She said "Well he should just come home and get in here and help me." No sympathy, no thought that if he came home he would be tired, nothing. I don't think she has ever told him "sorry about your mom". She might have been demanding in the past, but she would never have behaved this way. I have also noticed date problems, the forgetting things and then blaming me, the insistence that she is right. Mine won't go for evaluation either, so that's hopeless, but its pretty obvious to me its dementia, only the cause is unknown. It does help to feel certain its an illness, because otherwise I'd be hurt by her callousness.

 
Old 12-16-2008, 01:15 PM   #12
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Re: Help needed to understand what is going on

Quetzalmom- Yes, there seems to be an uncanny similarity between my mom in law and your mom. But, with this likely being an illness--probably dementia, I suppose it really is not surprising.
That is really quite a sad story you related abour your husband at his mom's bedside on the cooler and your mom's "has rosa died yet?"and demanding he then come to help her. And, your mom's failure to show any sympathy when Rosa died. That is so sad. Those are the moments that really tell us something is wrong. Thank you for sharing what must have shocked and unsettled you. I am sorry that you have had to go through this too. My mom in law really said nothing about my parents passing either.
I am trying to "understand " my mom in law and do not want my heart to harden to her. My fear over the past few years has been that in a way if I let her shape our relationship into this cold, uncaring thing that she seemed to want that I would become like her . And, that my relationship with her son would be like hers with him--no depth. And also a fear that our relationship would mirror her marital relationship that seemed so rigid and cold.
To play be her rules to talk about nothing but the weather seems like madness to me. It makes me feel dead . I wanted to lure her out of this frozen place . Have you felt this too?
I think about her death and what that will feel like for us. We seem to have lost her already.
Also, I feel that so many of her choices to be cold and narrow minded ( I regret to say that she would from time to time utter racial slurs )--these things have poisoned her over the years. Now maybe it is the dementia, but she set a course toward hard heartedness sometime ago.It simply was never a priority for her to show kindness. It is a pity.
All the legal pieces are in place, power of attorney, living trusts etc. As I said my husband (mostly) and his brother deal with the checks for the big items. She does write some small checks still. The agent at the brokerage(who has known them for prob. 20plus years) watches over her account. She has more than adequate funds but lives only on a small fraction and pinches pennies needlessly.She has been tight with money for as long as I have known her. We have assured her so many times that her resources are adequate-no need to pinch pennies--If her condition deteriorates, she can move into assisted care at the facility. She accepts that because she feels it will happen at some time. So, knowing her as I do , I do not feel anything more is possible now.
I should say too that because she really was cool to both her sons that neither seems emotionally engaged with her now.

 
Old 12-16-2008, 01:36 PM   #13
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Re: Help needed to understand what is going on

I don't know much, but I'm pretty sure the first rule in dealing with this is to accept that you can't fix everything. My mom never wanted to cultivate any friends or interests when she was young. I can't change her now, nor do I feel responsible for her loneliness or boredom. She won't even attend family functions at my home because she's oh so sick (she's not). I don't think your chilly relationship with your MIL will have to affect your other relationships. You owe her only a duty of respect and kindness, more would be nice, but if she can't, she can't. Support your husband, live your own life. Does that make sense?
Q
PS Mine can be a bit of a racist too. She's never really warmed to my adopted son, sometimes she treats him like furniture.

 
Old 12-16-2008, 01:55 PM   #14
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Re: Help needed to understand what is going on

Quetzalmom-
Yes, I think this has been harder for me than it had to be --because I hoped that we could be close. I have had to let go of that and am just beginning to ACCEPT what is. That is a big lesson for me in this .
Sorry to hear your mom treats your adopted son like furniture. That is sort of how we all are to my mom in law-but she has uses that she puts her sons to. To do lists that seem to hold the relationship together. And, these lists are fixated on.
I think at a time and it is probably reduced cognitive abilities that they have no room for anyone else in their head. Really it is just her sons that she acknowledges. Her daughters in law are superfluous-an added complexity that she doesn't want.
What was going on just wore on me, now that I think I can see if for what it is --in some way it feels liberating. Sad but liberating. Is that understandable?

 
Old 12-16-2008, 05:13 PM   #15
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Re: Help needed to understand what is going on

Sad, but liberating...is that understandable? Absofreakinglutely!!!
Q

 
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