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Old 02-28-2005, 09:33 AM   #1
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Red face Hey Shore- from Spuds- was in hospital 24-27

hey dave, I'm sorry, Early thursday morn like 4am I woke up with such excruciating pain in my lungs i coudn't breathe, yet there was a lot to cough out.but the pain wouldn't allow me to expand my lungs to inhale . thought i was having an asthma attack, but never had the pain before. lucky i was tired and went to bed with my clothes on wed. night, had to call 911, turned out it was a horriffic case of impacted pneumonia. no tests caugt it,(i.e. chest x-rays clear) but increasing fever to 103 and rising. the thohht was i had pancreatitis because the pain was very low at the bottom of the lungs, then i had a cat scan which caught the pneumonia. (and i had stopped coughing long before that.)

now i have a horrible mess. I was in such horrible pain, they put me on a diaudid pump, that was pushing it into me continously and then when i pushed the button, which could be every 6 minutes(but i didn't push it evey 6 minutes and can't give you even an estimate i was so wracked with pain), a double dose was pushed in. But none of my regular pain meds were given, and i have no clue the dose of dilaudid i was getting, So after reading your answer, here i am at my parents (to make sure i am warm, i eat and rest) and back to square one with my pain meds, and i can't tell yet if the dilaudid has had or will have any effect. ya got a challenge if ya want one!!! please help!!! what a mess!!! I'll try to answer some questions now, and I may have to come back, my dad is wanting the computer. but the above was very important for you to know as well.

How is the pain with the msc - unfortunately, i haven't been smart and you've shown me that now. I've taken either a 40mg meth in the morn to stave off the w/d's, or if i take a 5/500 vicodin, and it seems like i only had to take one all day, and that was without the daily meth) and the msc seemed to work pretty well on the pain, but by its self, the msc needs help. but maybe if i quit taking some mscs while taking meth - well you said you could figure it out MY ANGEL. Lets start fresh on the next day. I took the meth 40mgsx4 except at the end for about 2 weeks x5 a day. You can for get the 5 day serum level thing because I have taken two meth since out of the hosp. please re-evaluate my horriffic situation and start over! SORRY! BUT YOU ARE SAVING MY LIFE AND SANITY. i don't have to tell you that. thank you, Dave, it's not enough.

 
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Old 03-01-2005, 05:16 AM   #2
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Re: Hey Shore- from Spuds- was in hospital 24-27

hey Dave - I for got to mention that while I'm at my parents here for approx 4-5 more days i have only 7 more 40mgmeth. At home, I have 150 40mg meth, but i also have 500 mls of 10mg/ml of liquid meth which has an expiration date of o1/05, and i will (sorry) practically insist on getting rid of that first (OK? {:~(worried)) ? my dose whil taking that was 15 to 20 teaspoons per day. I would get 4 bottles, 2000ml's at a time. so there's a little more thrown at ya to calculate in. If you say, Hey lady, you are too screwed up, go back to your doc, I fully understand and sincerely hope we can remain good friends on here forever anyway! I sure hope you are ok. Please let me know how you are or direct me to a thread where I can read about your health and stuff. I AM concerned about you, but much too often that doesn't come out when you're in a PANIC mode. Please forgive me for being so selfish after everything you've done for me and, I see, everyone else here. Luv ya much. I really do. Leia

 
Old 03-01-2005, 06:09 AM   #3
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Re: Hey Shore- from Spuds- was in hospital 24-27

Hi Leia,
I know you have been writing for Dave and there is no answer yet so I don't know if I can help at all but I am a Dr.s daughter and have been around chronic pain a long time and if I can answer any questions or help you at all while waiting for Shoreline I would be glad to try. I have been on a Methadone Main. Therapy newsletter for a long time and read lots about it. Are you trying to figure out what yr dose should be? Do advise if anyone else can help you.
Sparkles
PS I did notice yr question about using your liquid meth first when you go home and that is perfectly alright. My only concern is while you are on a heavy narcotic, since you had breathing difficulty, you keep deep breathing in mind and try and move around to get up stuff in yr lungs.

Last edited by SheSparkles; 03-01-2005 at 06:11 AM.

 
Old 03-01-2005, 08:31 AM   #4
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Re: Hey Shore- from Spuds- was in hospital 24-27

He leia, Have you been using the liquid meth for BT or was that just how you started? If your were taking 10 or more teaspoons a day, am I wrong when I convert 10mg per ml and 5ml per teaspoon to 50 mgs of meth per teaspoon X 10, that's 500 mgs per day? 10 - 15 teaspoons is 500-750 mgs of meth per day. I really don't know how to comfortably convert you from a high dose of meth to such a low dose of morphine.

Using vicodin to supplement the MSC shouldn't be a problem as long as your not taking a full dose of MSC plus a lot of meth still. Having already gone 4 days without any meth, You have made a huge step already. IF you have been using the liquid meth for BT it may put your daily dose much higher than I could comfortably bring you off, given the amount of morphine you have.

I think your definitely going to need more morphine but you also need to be able to slow down the increases of morphine once you find a level of pain you can live with while you finish tapering off the meth. There will be a point that extra morphine won't stop all the meth ickies. So you have to ride out the ickies and then make your final adjustments, but I would think you need some early adjustments before you worry about fine tuning the morphine.

You are probably going to feel bad at some point and there is no getting around it or you will end up starting on an ouragous dose and having to back down. Going from 500-750 mgs of meth too 160-200 is a huge step. I have seen higher doses of meth before, My pump is running fairly high so please don't think I'm judging anything based on number of mgs. I'm just looking at where you were to what you have to work with. I also need to be really clear about where you were if you used BT meth.

I'm not comfy telling you to take additional meth with the full dose of morphine he has prescribed. I'm pretty sure you will need more morphine but It's not my place to tell you to do other than your doc has, especially when it comes to daily doses.

If your dose was steady at 160 to 200 it can be done, I was at 150mgs of meth per day when they switched me to the pump and at 120 when I switched back and forth between meth and morphine, but it took a lot of morphine to get the same relief. Depending on your docs comfort prescribing morphine will make a big difference in how fast you get the pain back under control.

I wanted off the meth so although I had plenty to work with I ust suckd it up for 2 weeks. I'm nt implying I did it s o anyone can, I just wanted off it that bad that the sooner the better and didn't want to drag it out. If you stop the meth cold the way I did, you know feeling the ickies will only last so long, about 2 weeks. It wouldn't be as smooth as you may be hoping, but it has a end point and then it's just a matter of getting the morphine right. Unfortunately I have no control over that aspect.

If you could reduce your dose of meth to the bear minumum it will make a cold switch easier when you do it, or we could try to do a variable taper bringing the meth down as you bring the morphine up, but your don't have enough morpine to do this and likely get the same relief. We can make the withdrawal easier but it last longer and your pain level wil likely go up some.Then again, you may respond wonderfully to morphine and that dose will manage your pain in the long run. Have you taken morphine and that's why I asked what type of relief yu got frm taking a 60 mg MSC.

If you wanted to try swapping a couple doses of meth for a couple doses of morphine, you could do that in a couple weeks. I don't want to tell someone to exced their own docs conversion factors and causing you to run out early or be acused of self medicating.We even have to be compliant when the dose is wrong and just let them know. The vicodin won't hurt so if it helps use it as BT meds. Be careful you measure the liquid precisely and realize just one teaspoon is a third of your old dose.

Changing meds isn't usually particluarly pleasant because docs tend to start on the low side for safety reasons and work up. Because you may be seeing him in the next 2 weeks because it's been about 2 weeks since he ordered the change, , you know you have the opportunity to make adjustments at that time without having to call and be squeezed in because you feel bad.

If you can do 40meth-60msc-40meth-60msc, Stay there untill your body gets used to it, 5-7 days. 80 mgs of meth per day is enough to stop most of the withdrawal but may not be enough to manage pain. Idealy if you could drop the level of meth at each interval a little more before replacing it with MSC things will go smoother, Like going
30 meth-60msc- 30 meth- 60 msc. The drops wouldn't be as large but will take a little longer. After 30- 60-30-60 then go 40-60-60-60, If you could decrease a little meth every other day fluxing between 40 and 30 for the first few days your meth serum level will slowly drop untill you can get by with just 30, at that point you would have certainly seen your doc and we would have more to work with.

What you will likey find is you can drop down untill you reach a point that any less does make you feel bad and prolonging it by tapering through the last 30-40 mgs isn't worth feeling funky that long. If your morphine has been increased by then just DC the remainder of the meth and see how you are 2 weeks later after all the ickies are over and you are simply dealing with pain. If you want to be done with the meth, you should have an apt close to make any needed adjustments in your MSC dose.

It did take 4 adjustments to get my dose correct, they were grerat about squeezing me inn to make adjustments.

If you need an extra 10 mgs of meth at night to avoid shaking or restless leg it's OK to take a little step back but Unless I'm very confused now by your dose of meth your going to need an increase in MSC. The next step would likely be 100MSC X 3 or 4. We can deal with pain as it's not something new, the withdrawal is really what I would be trying to limit by doing a crossover taper. Adjustments in MSC would be entirely up to your doc and his comfort level though.
When is your next apt ?

Maybe I'm confused about the liquid meth and that's just how you started and now you have been stable on the diskettes for a year, If that's the case, IT won't be that difficult to figure out a taper.

Another option is stay at 80 of meth and 120 of MSC and wait untill 5 days before your apt and completely switch, this will let your doc see what kind of shape your in so he can make adjustments.

It doesn't need to be terribly complicated but I definitely need to know exactly how much meth you were taking. I think the liquid just has me confused and you may not have realized how many mgs you were taking per liquid dose. Was it hard to back down from 500 mgs of meth per day to 160 -200? What did you experience then?
Can you double check your numbers, 10 mgs per ml is 50 mgs per teaspoon and let me know if you use it for BT or what you use?

But having gone 4 days without is a great start. Try not to exceed the 80 mgs a day you took yesterday and don't exced the the number of doses your replacing. IF you take 2 doses of meth try to limit to 2 doses of MSC and minimum use of meth as BT, Vicodin would be better to simply manage the pain rather than ending up using as much meth as BT as you were taking before.

Pain wise you sould get better pain contrlol by taking a steady dose like
40meth-60MSC-40meth-60MSC. It's 12 hours between doses of meth, keeps the meth level stable and you won't have to take a large dose to get a grip.

Sorry to hear about the hospital saty, That's never fun.
I'll check back and let me know if you think you can do 40-60-40-60 alternating meth and MSC.
Take care, Dave

Last edited by Shoreline; 03-01-2005 at 08:52 AM.

 
Old 03-01-2005, 10:49 AM   #5
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Re: Hey Shore- from Spuds- was in hospital 24-27

OH,OH - i spoke before I did any calcs, and this is the deal. I'm so sorry for being confusing. never never NEVER was I ever on that high a dose of meth. FORGET THE LIQUID METH! the mistake I made with the liquid meth dose threw us. it's simply an unopened bottle and the dose my doc had me taking was the same - 150-200mg. I was just saying, you wanted to know how much meth I had, for a transitional taper and I have 150 40mgtabs which expire in 2007, and a bottle of 500ml's of meth, which expired Feb2005 and I just wanted to use that up in your transitional taper first before the tabs.

Like I said, right now I am recovering at my parents 2 hours away from my house and had to guess at the liquid dose. I was on the liquid dose of meth about 3 years ago, but it has alcohol in it and it tastes horrible. Here at my mom and dad's I HAVE been taking a mixture of 1 40 mg meth a day, 1 60 msc a day, and i still have all those vicodins. Here at my parents I have only like 6 or 7 40mg meth for 5 or 6 more days here. i HAVE NOT BEEN A DAY WITHOUT METH since my switch to msc except the first 3 days, then I got terribly terribly sick and started taking 1 40 mg meth a day with my msc. Then you talked about- well, Dave, I hate to do this to ya, but sweetie could you re-read your the" i know there's knowledge out there' post again to get us back on the right track? I just re-read it myself, and that's EXACTLY what I need from you!!!!!!!!!. But now remember I was in the hospital and got lots of dilaudid and have no idea how much -ithink 32.6 over my 4 day stay by pump. that throws a wrench.

PLEASE HELP LIKE YOU WERE GONNA IN THE OTHER THREAD - I'M FEELING REAL BAD AND DON'T KNOW WHAT TO DO! Thanks Dave Leia DON'T LET THE MISTAKEN LIQUID DOSE THROW YOU, AND I HAVE NOT BEEN WITHOUT METH! I LUV YA, MY ANGEL!



To She Sparkles - how awesome of you to want to help! My story is pretty straight switched from 160-200mgmeth daily to 240mgms-contin daily. Not trying to be a jerk, but you can read mine and Dave's communication and see exactly what we're talking about if you go to the thread "I know there's knowledge out here" and I was actually praying Dave would still be here, If you also have any advice how to get through this, especially short term, I know dave said he was gonna "think of a transitional taper" and get back to me before I BLEW IT with the liquid meth thing. I obviously guessed the wrong dose.

I was just saying, he wanted to know how much meth I had, and I have 150 40mgtabs which expire in 2007, and a bottle of 500ml's of meth, which expired Feb2005 and I just wanted to use that up in his transitional taper first before the tabs.

Anyway, you are so sweet, thank you for your concern! I can't write long because I'm on my parents computer-ya know, their phone. they're being wonderful as it is! Leia

Last edited by Spuds; 03-01-2005 at 10:54 AM.

 
Old 03-01-2005, 11:32 AM   #6
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Re: Hey Shore- from Spuds- was in hospital 24-27

Hi again Leia,
You are certainly not being a jerk to be concerned about med. amounts and safe limits. I think the biggest concern with methadone is always the long half life and to not start taking too big a dose right away. I say things simply...I don't have the smarts or the ability to write things in as much depth/detail as Shoreline, but methadone is a med to be extra careful with. I wasn't trying to butt in but I could hear a bit of panic in your postings and didn't want you to think you were writing notes off into the wind with no one reading or concerned. How are your lungs now? And you go home soon. Just go easy on the methadone and err on the side of safety. That is one narcotic I have not been on; but am always aware of the build up unlike so many other narcotics. Continue on the upswing.....
Sparkles

 
Old 03-01-2005, 03:27 PM   #7
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Re: Hey Shore- from Spuds- was in hospital 24-27

Thank you! My lungs are great. I was hooked up to like 8 different kinds of abs, and i have asthma anyway, but i exercise my lungs with an awesome spirometer and i have an inhaler i use. thanks for everything. Please keep writing! You're so positive!
see, my doc has switched me OFF METH and ONTO MS-CONTIN.

Dave is trying to figure out how to best go thru the switch. DAVE - what if we forget the meth alltogether after 2 weeks or so, or starting now since i only take one 40, and not the full dose of msc, and try to get me by with the tons of vicodins, somas, and ativans I have? Any thoughts? I just hate to take 1 40 of meth for 7 days, then go up. Lets do this! But I still want lots of drugs for relief (my other ones). now is a good time for me to maybe get another refill on the vicodin, well in a month or so, but I still have almost 100-120. WHATCHYA SAY??? ANGEL????? ps - I'm handling the pain so far so good. I'm terrified if w/d's!!!

Last edited by Spuds; 03-01-2005 at 03:35 PM.

 
Old 03-02-2005, 06:06 AM   #8
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Re: Hey Shore- from Spuds- was in hospital 24-27

Hey Leia, Pain wise you sould get better pain contrlol by taking a steady dose like
40meth-60MSC-40meth-60MSC. It's 12 hours between doses of meth, keeps the meth level stable and you won't have to take a large dose to get a grip.

Half meth and half morphine isn't a bad starting place, you do have to get used to that amount or stay at that level untill you a have access to more morphine/ next apt. Don't owrry about the dilaudid, that was just 3 days, It may have managed pain much better but there is a big difference between IV and oral meds. I would expect you to have some increase in pain but you need to guide me as to how rough it is.

I'll check back and let me know if you think you can do 40-60-40-60 alternating meth and MSC. Your not being a pest, I just don't want to say it's OK to disregard your doc entirely. IF 50/50 isn't cutting it , but you can manage untill you ee the doc again, it would give yu a better idea of what you can tolerate. If 50/50 causes your pain to increae, supplement with what you can as far as Vicodin and if you find you need an extra 10 mgs of meth it's OK to take a small step back, catch your breath and try again tomorrow.
IF you can manage at 50% meth/50% morphine let me know how yorur doing and we can make some more adjustments,You would likely need to stay there for 5-7 days before making another change, the main goal is to stabalize on a dose so we can work from there.

I really need to know how you do at that level before planning future decreases, half way there is something and after you next apt, I would think if you not getting pain relief the doc would increase the morphine and give you more to work with. When do you see you doc again?

We'll get their but it will take a few days at the same dose to adjust to each new change. If you can cut the meth by half and use 120mgs of morphie for 3-4 days without any major problems we can still get you completely off the meth without a lot of discomfort,Use the vicodin for pain as needed and let me know how your doing and know what you can tolerate before planning the next decrease. Hang in there, If you can get used to 1/2 your old meth and 1/2 the new morphine dose, we can get the rest of the way there. If that's to hard, your doc really needs to know your under medicated and make some adjustments that will manage your pain and give me more room to work, without recomending you exceed the docs presecribed 240 of MSC. Your doc should really be expectingto hear from you because rarely can a conversion be done in one shot without some fine tuning. Let me know what you think and how your doing.
Take care, Dave

 
Old 03-02-2005, 07:58 AM   #9
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Re: Hey Shore- from Spuds- was in hospital 24-27

[QUOTE=Shoreline] I just don't want to say it's OK to disregard your doc entirely.

Hi Leia,
This was exactly what I was thinking. If you get too far from your Dr.s plan and forget that perhaps you changed things on him or her..feelings can go downhill quickly. After all..yr Dr. has your history charted and really has the best overview of what you need. Posters can help but with narcotics I am sure yr Dr. needs to feel heard above anyone else.
Sparkles

 
Old 03-02-2005, 11:57 AM   #10
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Re: Hey Shore- from Spuds- was in hospital 24-27

Thank you - i am gonna start that this afternoon since it's 3:00 pm now. I''ll start with my msc dose now, then my meth dose tonight because my meth dose will hold better. i STILL feel those DAM bt pains after taking the msc. No, my doc does not believe in bt meds. but like I said I got 'em, and don't use them hardly ever because I truly try to obey his orders. But I'm not an idiot. I take one when I have to. Then I'll give you a day off!!! A complete day, and then let you know how it did. I did talk to my doc today, but it was because I thought I was going thru more w/d's, so I today I've taken 2 msc's, no meth, 2 or 3 somas, 2 ativan, 2 vicodin. He just said it should start getting better and called in a script of phenergen. I heard that adds some potency to narcotics. is that right? I'll check back with you tonight to see if you have changed your mind with any of the info I've given you today. PS - This is day 2 without meth. But day 2 with mucho pain. thanks again, angel. leia

one thing - I'm nervous about running low on meth - this reason is why i saved up so much!

Last edited by Spuds; 03-02-2005 at 12:01 PM.

 
Old 03-03-2005, 05:43 AM   #11
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Re: Hey Shore- from Spuds- was in hospital 24-27

Hey leigh, like sparkles said, I don't want to over ride the docs orders, but as long as your not taking more MSC than prescribed and decreasing the meth your on the right track. A 50/50transitionlal taper won't exceed the dose he had you on in the past and wants to steer your towards a working dose of MSC.

I didn't realize you had ativan. That' will help greatly with the restless leg and jumpiness in your muscles you may feel, als with sleep, just keep in mind you don't want to run out of ativan early if it's a maint med. Phenergan will help with nausea more than it's going to potentiate the opiates. If you can get through a week of the 50/50 th nest step wold be 25% of your old meth dose and 3 doses of 60mg MSC. It truly sounds like he's willing to help make the transtion easier and if you go in and say I'm still taking 1/4 of the meth and 3/4 of the MSC your really not exceeding the number of MGS he intended. It is a touchy subject though when stepping in and doing it a different way than your doc sugested, but I honestly believe it's an easier way and we know our bodies and how much ickiness we can tolerate. It's not qite as simple as hopping from one med to the ther using a chart. Your reporting to him as far as pain levels and symptoms is more important than telling me you feel bad.

With the benzo, the Vicodin and phenergan, you have all the tools as far as combatting withdrawal I would suggest. It will likely go smoother than you think once you are used to the 50/50 split.

Excepting you may have an increase in pain is just part of the process, adjustments can be made to manage the pain, but simply adjusting the morphine to combat the differntial withdrawal really won't help that aspect of the transition. If you can go 50/50 for a week, lets see how your feeling and take it from there, at any point if your not comfy, call your doc and explain how you have stoped half the meth and started half the morpine and I doubt your doc will have a problem as we haven't exceeded his ratio or conversion rate.

Fine tuning the morphine can always be done. A little extra pain now isn't a huge price to find better relief with a med with less side effects if it works out that way, as long as there is light at the end of the tunnel it's not so bad. Some people simply do better on meth and some can't tolerate the side effects. Personally my head was much clearer off meth and on morphine.

Good luck and keep us posted.You do have the Vicodin if you need extra relief between meth doses so just stay within the tylenol guidelines, 1000mgs per dose 4000 mgs per day as you get through this. Hydro is about 80% as strong as morphine mg to mg so it will give you an idea of how much additional morphine you may need once the meth is out of your system.
Good luck and Take care, Dave

Last edited by Shoreline; 03-03-2005 at 05:50 AM.

 
Old 03-03-2005, 11:58 AM   #12
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Re: Hey Shore- from Spuds- was in hospital 24-27

I hope you get this Dave - You have exhausted your info, I can tell, and with all that info I have all the tools I need. Thank you for all this. I wish there was something I could do for you, but if I can just remain your buddy, is that ok, Angel? leia

 
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