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Old 06-05-2010, 07:44 PM   #1
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Euflexxa (HA) Injections In Knee

I received my first of three Euflexxa hyaluronic acid (HA) injection for my osteoarthritis knee on Friday.

I'm curious to know if anyone else has received Euflexxa injections for an OA knee and what the results were.

Last edited by Koot; 06-06-2010 at 11:20 AM.

 
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Old 06-06-2010, 05:27 AM   #2
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Re: Euflexxa (HA) Injections In Knee

Not sure on the brand name you mentioned, but I have had Synvisc injections, first the series of 3 then the new Synvisc One (which I prefer). In my case I had the series of 3, three times. Each time the benefit was about 6 months. I then had the 1 shot last June. On Janurary 17th I had my latest "Rageing Flairup" as my doctor called it. It was at that point that I made the decision to have TKR. I had the right knee done on 3-31-10 and will have the left done 7-7-10.

Generally though, the shots last six months.
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Old 06-06-2010, 11:19 AM   #3
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Re: Euflexxa (HA) Injections In Knee

Quote:
Originally Posted by jerseyboy View Post
Not sure on the brand name you mentioned, but I have had Synvisc injections, first the series of 3 then the new Synvisc One (which I prefer). In my case I had the series of 3, three times. Each time the benefit was about 6 months. I then had the 1 shot last June. On Janurary 17th I had my latest "Rageing Flairup" as my doctor called it. It was at that point that I made the decision to have TKR. I had the right knee done on 3-31-10 and will have the left done 7-7-10.

Generally though, the shots last six months.
Thanks for the information on your Synvisc injections.

Here's my story:

The Euflexxa injections that I'm receiving are a product of Ferring Pharma. This HA is not made from processed chicken or rooster combs, which eliminates the chance of an allergic response in people sensitive to poultry products. It is manufactured through bacterial fermentation - also known as bioengineering, which is an everyday manufacturing process. Rarely do people have a flair or any negative side affects.

I damaged my knee (hyper-extended with torn medial meniscus cartilage)about 30 years ago. On the suggestion from the doctor that originally examined me he recommended that I wait until arthroscopic surgery was commonplace. I waited far too long and didn't have surgery done for 17 years after I damaged it. By then I was bone-on-bone and had arthritis.

For 30 years (since I damaged it), my knee has not felt right. Even after having the arthroscopic surgery (13 years ago) my knee has never felt right. My range of motion was limited and I could not fully extend my leg, therefore (as the doctor described it) I could not "fire my quad muscle, which allows you to walk properly. Walking only five blocks caused my knee (leg) to really tighten up and my knee to swell up and get puffy. Medication helped, but was not doing much.

Recently my knee had been getting much worse where I couldn't walk more than five blocks before I was stiff-legged and in a lot of pain. So I went to see a new doctor about a month ago. He specializes in knees with particular focus in athletic injuries. He took x-rays of my knee and told me I was a candidate for TKR, but that I was too young (at 60 years-old) because I would likely need a 2nd TKR if I lived to be an average age...and a 2nd TKR is almost always troublesome to do and doesn't workout too well. So, he highly recommended that we do whatever was necessary to "buy some time" before I had to have a TKR.

When I was in the doctor's office my knee was pretty swollen and puffy, and obviously it had a good amount of effusion (fluid) surrounding the knee joint. However, instead of draining the fluid from my knee he wanted to see what the affects of a cortisone shot would do for my inflammation. Believe it or not - I have never had a cortisone shot in my knee before...even though I have been battling a bad knee and pain for 30 years. He said if the cortisone relieved my inflammation that I would be an excellent candidate for Euflexxa, which would provide the best lubricate for my knee joint. He said that my body was no longer producing ample lubricating fluid for my osteoarthritis knee joint - that the natural lubricating fluid was minimal, thin and ineffective, which causes pain, swelling and tenderness around the joint. He said my OA bone-on-bone knee joint was like a crusty old rusty door hinge with a little water on it instead of being slippery and smooth...and because it's a weight-bearing joint whenever it's used (e.g. simply walking around) that's what causes the constant inflammation and pain. He told me I would always have the OA, but that Euflexxa should give me tremendous lubrication and greatly reduce the inflammation and pain.

He gave me the cortisone shot (just below the patella), which did not hurt at all and within a few hours I could detect that my knee was feeling oddly different - like it wasn't as mushy with inflammation. By the next morning my knee was almost the same size as my good knee and my range of motion was greatly improved. No longer was my damaged knee so inflamed that it bowed out (bowed), and I could straighten (extend) my leg almost straight. On a scale of 0-10 my pain and discomfort was always no less than a 7 and easily reached a 10 after walking or doing something that aggravated it. My pain had dropped to a 3 on the scale. By the second day after the cortisone shot my pain was a remarkable 1 on the pain scale. My knee had never felt better in the past 30 years! (Why I had never received a cortisone shot before is beyond me...) Anyway, I called the doctor's office to let them know the results of the cortisone shot and to proceed with the insurance approval and ordering the three Euflexxa injections.

I was told that it would likely take a few weeks to get insurance approval and to receive the Euflexxa, as the Euflexxa must be ordered on a patient-by-patient basis. After a couple of weeks I received a phone call from the doctor's office that my insurance (BCBS) approved the Euflexxa and to be expecting a call from a pharmacy that would be shipping the drug to my doctor's office, which happened a few days later.

When I went in for my 1st Euflexxa injection last Friday it had been one month exactly since I received the cortisone shot and my knee was still feeling great, even though I was told the cortisone wears-off after about ten days. I guess (since the cortisone wears-off in ten days) my inflammation is returning , but I certainly can't tell it. I almost hated to have anything more done to my knee because it was feeling so good.

On Friday I received a simply shot to numb my knee and after waiting ten minutes or so for it to take affect my knee was then drained of only 5 cc of effusion (fluid) and I received my 1st Euflexxa injection. I was told they always drain the knee at the site of the Euflexxa injection as standard practice. Fluid was not aspirated from the joint area. I did not feel a thing other than a tiny sting from the shot that numbed my knee except for the nurse applying some pressure with her hand to help extract (drain) my knee. The entire draining and injection procedure (after the numbing) took all of 3-5 minutes...and that included the application of a strip Band-aide just like with any shot.

I thought I would have my knee joint drained and receive the Euflexxa injection in the joint area. However, that wasn't the case. With my leg in the straight (extended) position the numbing shot as well as the effusion aspiration and Euflexxa injection was performed on the outside (lateral) of my leg above my kneecap even though my cartilage damage is on the inside (medial) of my knee. (I've learned that there are four injection sites that can be used, but the location where they did mine is the least likely to cause any damage or pain.) A 1 1/4" long 25-gauge needle was used, which was angled downward and under the patella at about 35 degrees to first drain (aspirate effusion) the knee...and then the aspiration syringe was removed and the same needle was used to inject the Euflexxa. Fluid was not aspirated from the knee joint itself. (For the benefit of others reading this that may be anxious or afraid of the procedure or experiencing pain - I did not feel a thing. I left the doctor's office feeling just as good as when I arrived. I had a strip Band-aide on the outer part of my leg just above my kneecap covering a tiny little needle mark the size of a ball-point pen tip.)

I was told not to stand on my feet for long periods of time and not to do anything strenuous (lifting heavy weights, playing tennis, etc.) for two days. I assume it takes a couple of days for the Euflexxa to get into the joint area or through the tissue where it was injected - dunno.

It's now been two days (48 hours) since my knee was injected with Euflexxa. During the first 24 hours I sometimes felt a very tiny burning sensation on the inside (medial) of my knee where my knee is bone-on-bone. It's hardly worth mentioning because it was barely noticeable. I no longer detect that sensation and my knee continues to feel great.

I understand that most people receiving HA injections do not feel any benefits until after the 2nd or 3rd injection, and many don't feel benefits until 12 weeks. I don't know if benefits are felt any sooner with Euflexxa versus other HA type injections. Obviously I am still feeling the benefits of the cortisone shot I received one month ago.

I hope that the 2nd and 3rd Euflexxa injections will be as easy as the first was. (By the way, I was told that each injection [spaced one week apart] will be given in the same area.) I'm hopeful the Euflexxa will lubricate my knee joint and eliminate (or greatly reduce) any inflammation that I have previously experienced all these years. That's what it's supposed to do. It's supposed to last at least six months, but I've heard that some experience benefits lasting a year or longer. I guess every person's knee joint problem is different and some people's bodies respond differently to medications and treatment. Maybe I'm just lucky that the cortisone helped me so much. I hope that's a good indicator that the Euflexxa will do the same...and last a long time.

There's nothing better than going from a constant 7-10 pain scale level (on a scale of 0-10) for 30 long years all the way down to a 1 pain level. I want that to continue! Talk about "buying some time" before needing a TKR - my knee feels almost as good as it did before I damaged it in my late 20s! If I can keep my knee to continue feeling anything close to this good I shouldn't ever need a TKR. We'll see how it goes!

Last edited by Koot; 06-06-2010 at 01:04 PM.

 
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Old 06-06-2010, 12:57 PM   #4
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Re: Euflexxa (HA) Injections In Knee

What a story! Very well written. Sounds to me like you have found what you were looking for. With the Synvisc shots I was able to postpone my surgery for 3 years. I got to the point where I was havine too many flairups. The last one took me a little over 3 months before it felt really good again (just prior to 3-31-10 surgery as a matter of fact). So, I thought if it takes three months to come back from a flairup, and it takes three months to come back from TKR, why not! Sure I would have liked to have put another few years behind me, but now I'm glad I went for it. Couldn't see the point of going 6 months at a time, then experiencing yet another flairup. I have heard revisions are tougher but if these knees last me 20-25 years like they are supposed to, well I'll deal with it then I guess
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Old 06-06-2010, 02:21 PM   #5
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Re: Euflexxa (HA) Injections In Knee

Quote:
Originally Posted by jerseyboy View Post
...With the Synvisc shots I was able to postpone my surgery for 3 years. I got to the point where I was havine too many flairups...

Koot's story...
I'm pre-surgical for two TKRs having injured, like you, my right knee about 10 years ago. Of all things, I hyper-extended it pulling to a suitcase, but is was New Year's Eve and I wasn't about to stay in the hotel room! Fade to present time...I didn't take of my knee and the years, and weight, and the genetics see me now with bone-in-bone medial right knee and bone-on-bone medial left knee.

I have to say the Synvisc injections are VERY effective. However, because of the current degenration of my right knee, I experienced a setback from the recent therapy. The fluid dislodged some bone spurs and I was non-ambulatory for three days, and in a lot of pain. My knees are much better now and I'm looking forward to the rest of the six months of reasonable mobility. I'm also using topical Voltaren, which I call, "PFM Cream" (Pure Flippin' Magic). I believe it's so effective because I came from using nothing -- very similar to your cortisone injections. I had some of those, but had to limit it because of the glucose effect.

This story has an ending, however, that's the surgery. But, like you, as long as these modalities are working, I'm going to wait as long as possible. While I'm waiting, though, I'm preparing for the eventuality. That means strengthing those muscles around the knees, losing the weight, and learning as much as possible about this very necessary, yet involved surgery and recovery.

I would question your doctor's hestitancy of surgery at your age. There are some people throughout these boards having replacement in their 40s! And that's what I heard these last 10 years, "You're too young" -- I'm 57 now. This time, the doctor didn't hesitate recommending the surgeries. The new bionics last much longer and are custom fitted to your joints. We don't want to wait too long, however, just because of general health issues.

Good luck with your current treatments, but start the process of getting ready for surgery -- that's what I'm doing and I'm feeling so positive about it.

Keep us posted!
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Old 06-06-2010, 07:39 PM   #6
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Re: Euflexxa (HA) Injections In Knee

Thanks 2infla and jerseyboy for the posts!

I am hoping there are some people here that have received Euflexxa and can offer some information on the results they experienced. Certainly someone has received Euflexxa HA injections for their knee.

Euflexxa was FDA approved in late 2004 as the first [and maybe still the only] non-avian HA therapy. Clinical studies of people treated with Euflexxa reported the highest pain relief, increased mobility and decreased stiffness among all brands of HA therapy. In fact, 81% of those who received Euflexxa indicated they were "satisfied" or "very satisfied" with the treatment.

I cannot imagine that doctors are still offering the old, original HA treatments and not offering this pure bioengineered treatment that scores higher and has far less chance of allergic response in sensitive people. My doctor said he switched over many years ago and has had much better success.

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Old 06-07-2010, 07:58 AM   #7
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Re: Euflexxa (HA) Injections In Knee

I'm only 60 and had my LTKR on 11/30/09. It was by far the best thing I've done. I hope your shots work but if they don't I'd say don't hesitate on the TKR. My only regret is that I waited because I thought I was too young.

I also had a very serious injury many years ago and my knee was never right after that. Over time it just got worse and worse to the point where I couldn't straighten, couldn't walk a few blocks, it would get swollen, could hardly bend it once I walked too much pain would be excruciating,etc.

I finally had a dr. who suggested trying cortisone. I did and it was like I had a new knee. I was so happy. But it didn't last but for maybe 6 weeks. The second shot was less successful. I wanted to avoid the TKR and try the Effluexa but my dr. said it was not likely to work because of the amount of arthritis in my knee.

In any case, I finally got up the courage to get my knee replaced. It was six months last week and I can now walk as far as I want to, my leg can be totally straight. I can stand on my bad knee without fear of falling, go up and down stairs normally without even holding the handrails, ride my bike, etc. It's like I got a new life. I've been good since about 3 months after the surgery but continue to improve. The first several weeks were awful but once I got through those it's been uphill ever since.

Only if you've experienced the inability to walk can you possibly appreciate how good you feel later. I still look back and wonder why I waited so long when it was inevitable anyway.

If I someday need a revision then so be it. They are perfecting those more and more every day. I also opted for a younger surgeon who specializes in the quad sparing (minimally invasive)surgery and who will be able to do a revision should I ever need it as that's one of his specialties.

 
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Old 06-09-2010, 08:32 PM   #8
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Re: Euflexxa (HA) Injections In Knee

I had my 2nd Euflexxa injection today. This injection was two days early because of a scheduling problem, but the doctor said it wasn't a problem.

The knee draining and Euflexxa injection was done by the doctor this time, which was smooth as silk. All I felt was a little sting to numb my outer knee. The draining and injection was done about 1/4" from where the first one was done.

I only had 3 cc of fluid drained from my knee (compared to 5 cc a week ago), which the doctor said was a good sign that the first Euflexxa injection was already helping keep the inflammation in check.

Next Friday (6-18) I will receive my 3rd and last Euflexxa injection. So I guess my knee joint will be all greased up. Thus far my knee has not felt better since I damaged it 30 years ago.

I asked the doctor how many patients he had administered Euflexxa to and he said many hundreds. He said the product does very well for most people. I'm really surprised no one here has used Euflexxa and responded. Maybe they're off running a marathon or something...

I'll keep you posted on my results.

Last edited by Koot; 06-09-2010 at 08:35 PM.

 
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Old 06-18-2010, 12:12 PM   #9
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Re: Euflexxa (HA) Injections In Knee

I had my last (3rd of 3) Euflexxa injections today. Once again the draining and injection went smooth as silk. All I felt was a little sting to numb my outer knee.

I had 5 cc of fluid drained from my knee this time (compared to 5 cc prior to the 1st injection and 3 cc prior to the 2nd injection). The doctor told me my fluid buildup was remaining low, which was a good sign that my inflammation was not getting out-of-control. I told him that I'd been playing a lot of golf and practicing at the range recently.

The doctor wants to see me in 9 weeks (8/20) to check the results of the Euflexxa injections. He said that trials have indicated that many people do not often see results until some weeks after getting the injections. He seems to think that I am already seeing benefits of the Euflexxa injections. Also, he said that when he compares how I'm doing so far with hundreds of others that he has seen, that I might be one of those people that only need Euflexxa injections every year to 18 months. I certainly hope I can be pain-free for 12-18 months before having more injections. That would be nice...

PS - I asked the doctor if he ever used the "single-shot" Synvisc. I said he's only done three of them...and that the third person was getting the injection today. He said he did not have a high rate of success with the regular Synvisc [multiple] injections because the molecule size was too large and caused a lot of swelling for some people. Also, he said that Synvisc was made from poultry, which also caused problems with some people. However, he said the single-shot Synvisc had a smaller molecule size and that's why he wants to try it. He's administered all the HA treatments...and with the exception of not knowing how the one-shot Synvisc will workout - that Euflexxa has been the most successful of the HA treatments by far.

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Old 06-25-2010, 07:10 AM   #10
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Re: Euflexxa (HA) Injections In Knee

It's been a week since I received my 3rd (last) Euflexxa injection...and I'm happy to report that my knee is feeling absolutely great. I have no pain or stiffness, and it's obvious any inflammation I may have is minimal because my range-of-motion is almost the same as my good knee.

I've played golf three times since last Friday and after the round my knee is not swollen, stiff and in pain like it used to be after playing only 9 holes. What a relief...

With my knee no longer in pain and having almost a normal range-of-motion I have noticed the strength is building back up in my leg. I also no longer walk with a strange gate...and my leg is not bowed out anything near what it used to be. In fact, my walk (gate) appears normal, and my leg's appearance seems to be much more normal, instead of noticeably bow-legged.

My knee hasn't felt this good in 30 years! I did not realize just how much pain I constantly had (for decades) until recently.

 
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Old 06-27-2010, 07:17 AM   #11
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Re: Euflexxa (HA) Injections In Knee

Koot, that's great news

I wish something like that had have had long term relief for me. Surgery seemed to be the right answer in my case. I'll be glad to have it over and done, then I can get on with the business of living life
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Old 06-27-2010, 05:13 PM   #12
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Re: Euflexxa (HA) Injections In Knee

Koot:

Thanks for all the information and the great first post! I may be facing the use of this injection soon. I've had extensive right knee surgery but I am not at a point where a TKR is an option. Cortisone has worked a bit and I first have to see if I need an arthroscopy. If not Euflexxa may be in the plans IF my insurance agrees. For a few years they didn't approve this type of treatment and I don't have the cash to pay for it. The insurance coordinator at the orthopedic surgeon said it may be allowed in 2010 so I may move quick to get all 3 in before the end of 2010 in case the insurance company changes their mind...again.
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Old 06-27-2010, 05:26 PM   #13
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Re: Euflexxa (HA) Injections In Knee

Hi SpineAZ,
Don't know about Arizona, but in Florida pretty much any injection aside from cortisone needs pre approval from the insurance company. I hope you can get this series and that it works for you

TKR is definately the last resort. I tried different series for the last 4 or 5 years and now, here I am Good luck!
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Old 07-01-2010, 10:26 AM   #14
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Re: Euflexxa (HA) Injections In Knee

Koot,

Thanks so very much for the detailed postings on your journey with the Euflexxa injections. After suffering for over 5 years I've decided to go ahead and proceed with the injections starting this coming week (7/6). I had little success with my cervical and lumbar steriod injections in the past and was thinking that these injections were similar until I came across your post. My PM doc will be the one doing the injections which makes me way more comfortable than the ortho MD.

I'll post my results. Again thanks for the detailed info.

KG

 
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Old 07-01-2010, 10:55 AM   #15
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Re: Euflexxa (HA) Injections In Knee

Konagirl - The Euflexxa injections are working like a charm for me. I'm playing a lot of golf nowadays, which is something I could not do prior to the injections. When I did play golf I was stiff-legged with pain after playing the first 9 holes. Unreal the difference!

I hope it works as well for you...

 
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