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Old 10-26-2011, 11:46 AM   #1
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Unhappy Inadequate pain relief after emergency surgery..help!

Not long ago I posted messages on another part of this website regarding issues I've had with my bowels. On October 16th I went to the ER with abdominal pain and all that ER doc did was run an xray, pronounced that the pain was due to what I ate and she sent me home as I started feeling better. No blood work, ct scan, etc.h

The following day I returned as my pain got worse and I was running a fever. This time I had a different md and they did a ct scan. A surgeon came to me saying they found "free air" in my colon, meaning it was perforated. I had emergency surgery that evening. During the surgery, they found no perforation but air bubbles in the (mesentery?), which was fixed. I had an incarcerated hernia, which was repaired, many adhesions from previous surgeries were removed and my appendix was taken out as they were in there anyway.

So here I sit, more than a week after the surgery. I've got a laparotomy incision less than 12 inches long (staples). I'm in agony and was prescribed vicodin, which is doing nada for the pain. I might as well as take vitamins for all the good that stuff is doing me.

I begged the doctor to prescribe the pill form of dilaudid for me prior to being discharged but he said no. I called them again today and asked again, saying the pain was unbearable. It's been several hours and I have yet to hear back from his office.

What should I do? A home health aide is supposed to check on me this afternoon, but I don't know if they will even listen to her. Does anyone on this board have experience with this type of problem, and if so, how did you get help?

I am in so much pain I can't take it and am tempted to stay in bed 24/7. I can't even shower, even though the surgeon says I can. I cannot stand up that long.

Help!

 
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Old 10-26-2011, 12:26 PM   #2
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Re: Inadequate pain relief after emergency surgery..help!

I am sorry for the problems that you have been experiencing. Surgery is bad enough without having pain afterwards.

I can't say for sure, but part of the issue may be that you asked for a strong pain med by name. Unfortunately, when people ask for drugs by name and the patient isn't a long time client, the first thought they have is that you are a drug seeker. The people who abuse pain meds tend to do by name requests. You perhaps would have had better luck if you had called and said how the pain was acting and what you had done to bring it down but what you had wasn't working and what could they suggest you do.

We live in a world where too many have ruined it for those who are in true need of the meds. When the nurse comes, tell her what is happening and how you feel. And tell her that you probably made a mistake by asking for a med by name. My assumption is that you have used it before, which is why you asked for it by name. Explain what has happened and ask for her to intervene for you.

Good luck and I hope you get some relief...

 
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Old 10-26-2011, 12:51 PM   #3
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Re: Inadequate pain relief after emergency surgery..help!

I agree with Ibake&pray. It very well could be that because you asked for dilaudid, they felt that your pain this far out from surgery should be far less and dilaudid was not required. I am surprised that you are still in such severe pain this far out, it's almost two weeks now since your surgery.
Staying in bed is not going to help ease the pain, especially from abdominal surgery, the gas used to inflate the abdomen can become trapped if you aren't moving around to help it break up.
Then you can also develop more adhesions from not moving around. You don't want that, especially being that you have had them previously.
When do you see the surgeon to get the staples out? That should be coming up rather soon, I think that most staples come out around the 10-15 day marks.
I hope that you feel better soon and maybe now that you are two weeks out from your surgery, maybe the vicoden may work better for you.
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Old 10-26-2011, 12:55 PM   #4
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Re: Inadequate pain relief after emergency surgery..help!

I agree with I Bake, You don't ask for specific meds unless you have legit allergies. Every surgery I have ever had since my wisdome teeth, through 3 spinal fusions and everything in between, I have always been given 5 mg percocet as a discharge med and quickly step down from that to vicodin. Post op pain isn't like chronic pain where they are trying to make you as pain free as possible given a serious problem because it's a quality of life issue. This is short term post op, When you ask for something a doc rarely prescribes ou patient by name, you may as well have asked him to through a box of insulin syringes in their too.

Post op pain is treated differently than chronic pain. They don't want you feeling so well that you decide to take a bike ride where one fall could leave you guts hanging from your abdomin. If you ned to lay flat and cant partcicipate in PT or other therapy, the doc will get those notes. If it's completely unbearable you should be asking why, not for more drugs. Go to the ER if you cant wait for you post op apt. They can at least check your incision, do a Blood count and monitor your BP and pulse. Their going to call your surgeon and let him know they have his patient there so I wouldn't ask for more dilaudid, Go in doe eyed, unable to understand why your still in this much pain and let them find the cause and let the doc decide what the next step up in pain management should be rather than sugesting a highly absuable and easily injectable opiate. In the last 35 years and 20 plus surgeries including the last 6 level fusion, I came home with Percocet after every procedure, because that's what docs are tought is adaquate for discharge. I have never asks for anythinfg specific. Yes sometimes all I could do was spend a few weeks or months laying flat, but that's because they don't want you so comfy you hurt yourself after surgery. If the pain is relieved when you lay flat, then lay flat. Post op pain is not pain management and the goals are entirely different. The goal is to take the edge off while you heal without you causing more harm by being over medicated.
Good luck, Dave

 
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Old 10-26-2011, 04:31 PM   #5
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Re: Inadequate pain relief after emergency surgery..help!

First of all, I want to thank you all for the responses I received. I understand what you're saying about asking for a specific med, but the only reason I asked for Dilaudid is that it's the only thing that has worked since the surgery 9 days ago.

It is available in pill form. When a visiting nurse came to my home today, I told her about the pain issue and how my surgeon refused to prescribe Dilaudid. The only other alternative he offered was percocet, but I had problems with that a few months ago after a dental extraction. It gave me horrible stomach pains, and with my medical history - including IBS - taking that medication is out of the question.

Anyway, I told the visiting nurse that if they were concerned about my getting addicted to or abusing these drugs, I would turn over what I have left of the vicodin for proper disposal. I wouldn't have asked for Dilaudid if there was something better.

Moreover, they (the doctor's office) claimed I was given Motrin in the hospital but that isn't true. I was offered it but turned it down. I can't tolerate anything that has ibuprofen or aspirin because of other stomach issues.

I hope to get this JP drain and staples out on Friday. Maybe this nightmare will be over soon. My tolerance for pain was never high. Thanks for listening.

 
Old 10-26-2011, 06:15 PM   #6
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Re: Inadequate pain relief after emergency surgery..help!

I have mixed emotions about this. I totally get not asking for a specific pain med as that can be a red flag, but should it? If I have an issue with my doc, whether pain related or not I am usually familiar with what meds I have taken that work or do not. For example, I get chronic UTI's I did the bactrim, cipro thing then my doc prescribed Macrodantin. I knew that there was a stronger one similiar and asked for it by name, Macrobid. I also will ask for a broad spectrum antibiotic called Cefdinir. If I need something for nausea, I ask for Phenergan or Zofran. I already know I cannot take Reglan or Compazine. In fact, with chronic kidney stones it isn't unusual for me to tell the ER doc what type of IV fluids and at what rate! LOL

Why should pain meds be any different. Why should we have to suffer taking meds that we know do not work or give us untolerable side effects for days or weeks just to avoid being honest with the docs. I know we do not want to appear as addicts, but the time for game playing needs to stop. This needs to be on both sides. Will it ever? Unfortunately probably not except for the docs who are totally OK with the patient being involved and educated about both their illness and medications.

Sorry Dianajune, I didn't mean to hijack your post. I hope you are feeling better and sorry you had to suffer when you knew what would help but were unable to get it.

 
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Old 10-26-2011, 09:36 PM   #7
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Re: Inadequate pain relief after emergency surgery..help!

dianajune, You had this surgery on October 17th right? If so, it would make today the tenth day, not two weeks like others have said. Also you say that you have a 12 inch scar? This sounds like a very large surgery to me! My point being that the Vicodin probably wasn't enough to cover your pain. Could you explain more about your surgery? Just having the appendix out is a painful enough surgery on it's own, and it wasn't even done laproscopically, if I'm not mistaken...janiee

 
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Old 10-27-2011, 07:40 PM   #8
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Re: Inadequate pain relief after emergency surgery..help!

Quote:
Originally Posted by Boxerluver View Post
I have mixed emotions about this. I totally get not asking for a specific pain med as that can be a red flag, but should it? If I have an issue with my doc, whether pain related or not I am usually familiar with what meds I have taken that work or do not. For example, I get chronic UTI's I did the bactrim, cipro thing then my doc prescribed Macrodantin. I knew that there was a stronger one similiar and asked for it by name, Macrobid. I also will ask for a broad spectrum antibiotic called Cefdinir. If I need something for nausea, I ask for Phenergan or Zofran. I already know I cannot take Reglan or Compazine. In fact, with chronic kidney stones it isn't unusual for me to tell the ER doc what type of IV fluids and at what rate! LOL

Why should pain meds be any different. Why should we have to suffer taking meds that we know do not work or give us untolerable side effects for days or weeks just to avoid being honest with the docs. I know we do not want to appear as addicts, but the time for game playing needs to stop. This needs to be on both sides. Will it ever? Unfortunately probably not except for the docs who are totally OK with the patient being involved and educated about both their illness and medications.

Sorry Dianajune, I didn't mean to hijack your post. I hope you are feeling better and sorry you had to suffer when you knew what would help but were unable to get it.
Boxer:

You didn't hijack my post. Actually, I couldn't have said it better myself. Why should doctors think that if we ask for specific meds, that we're looking to abuse them? They shouldn't. I tried over and over to get that surgeon to understand why I cannot take percocet and even gave him the name of my dentist if he wanted proof. And they claim percocet is stronger than vicodin. Vicodin doesn't do much for my pain and I think it's partly to blame for my on and off nausea (unless that's the flagyl....tastes awful!).

Tomorrow I will see him and will emphasize what I said before, but I suspect it will go in one ear and out the other. Dilaudid worked better in the hospital than anything else for pain, and it is available in pill form. I'm even willing to make a high copayment to get relief. I used to be able to take percocet but have developed an intolerance for it.

It seems to me they gave me zofran in the hospital after the surgery, but I'm not sure. Anyway, at this point in time I'm on both flagyl and cipro for antiobiotics and vicodin. Juggling these drugs with the others I take can be challenging!

Thanks for listening!

Last edited by dianajune; 10-27-2011 at 07:46 PM.

 
Old 10-27-2011, 07:45 PM   #9
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Re: Inadequate pain relief after emergency surgery..help!

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Originally Posted by janiee08 View Post
dianajune, You had this surgery on October 17th right? If so, it would make today the tenth day, not two weeks like others have said. Also you say that you have a 12 inch scar? This sounds like a very large surgery to me! My point being that the Vicodin probably wasn't enough to cover your pain. Could you explain more about your surgery? Just having the appendix out is a painful enough surgery on it's own, and it wasn't even done laproscopically, if I'm not mistaken...janiee
Janie:

I went to the ER on October 16th and was sent home early the next morning. I was sick as a dog after getting up and found that I had a fever and the stomach pains got worse again. So, I went back to the ER and at least this time they did a ct scan, at which point they thought I had a perforated bowel.

Hence the emergency surgery, which I had that night. They found an incarcerated hernia and fixed that ( I previously had surgery for a strangulated hernia in '09), took out alot of adhesions and yanked out my appendix. Not that it needed to be, but because they were in there anyway. I think the surgeon did this to prevent a future surgery in case the appendix was to flare up.

You're right....this was a laparotomy, but I've had longer incisions than this one. At least it appears to have stopped draining towards the bottom of it, but the JP drain is still taking in fluid.

So, I will be surprised if my staples and JP comes out tomorrow. I sure hope so. Then I can bathe normally!

 
Old 10-28-2011, 10:11 AM   #10
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Re: Inadequate pain relief after emergency surgery..help!

Hi DianaJune,
I hope that your post op visit with the surgeon went better today and he at the least, listened to you regarding the pain you are still having. Is it easing up at all?
To those who commented about the two weeks post op comment I made, I said it was almost two weeks ago and that I was surprised that the pain hadn't lessened some. Normally, about the 10 day mark, things start to calm down some regarding post op pain levels. It was not a snide remark but one of curiousity.
Were you able to get the drain taken out today and the staples? Has the drainage lessened and is it clear? With two antibiotics , hopefully, you won't have any problems with infections.
I understand about the vicoden upsetting your stomach and the motrin products as well. I can't take vicoden at all, it upsets my stomach and causes severe nausea. Percocet does as well but for some strange reason, not quite so badly.
Anyway, I hope that your appointment went well and that you are soon on your way to feeling a lot better.
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Old 10-28-2011, 04:38 PM   #11
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Re: Inadequate pain relief after emergency surgery..help!

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Hi DianaJune,
I hope that your post op visit with the surgeon went better today and he at the least, listened to you regarding the pain you are still having. Is it easing up at all?
To those who commented about the two weeks post op comment I made, I said it was almost two weeks ago and that I was surprised that the pain hadn't lessened some. Normally, about the 10 day mark, things start to calm down some regarding post op pain levels. It was not a snide remark but one of curiousity.
Were you able to get the drain taken out today and the staples? Has the drainage lessened and is it clear? With two antibiotics , hopefully, you won't have any problems with infections.
I understand about the vicoden upsetting your stomach and the motrin products as well. I can't take vicoden at all, it upsets my stomach and causes severe nausea. Percocet does as well but for some strange reason, not quite so badly.
Anyway, I hope that your appointment went well and that you are soon on your way to feeling a lot better.
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My post-op visit went well, but my staples and JP drain will have to remain in place until at least Wednesday. My surgeon couldn't absolutely promise they'll come out then, but he was optimistic about it. Re. the pain, it has improved, but Vicodin doesn't do much except that I feel stoned!



Don't worry about your comment re. my pain. I didn't take it as being snide! As for the Vicodin, they want me to remain on it and he wrote another prescription just in case. He was very nice about our differences re. meds, but I doubt I'll get another refill. Re. the nausea, I think it's the Flagyl that's upsetting my stomach for the most part (or maybe the other anbiotic too). I can eat, brush my teeth and take mints and still taste that Flagyl several hours after having it! Yuck! heheheee

The drainage has lessened quite a bit, so I guess that's a good sign. I had to go to the store to get groceries and another prescription (not surgical-related) and did laundry. I had help, praise God! Dad took me to my appointment and lifted everything for me. The wound around my last JP drain seemed to leak more, but I think it was from the running around today. I'll try to not overdo it next time I go out.

The surgeon said my incision looks good, and it's not leaking any yellow fluid at all. It did for several days but appears to have stopped. However, I have a bump near my belly button and I'm hoping it's not more fluid collecting. That's what happened last time I had stomach surgery and would hate to have to keep this drain in place or find I have another infected seroma (like I did in '09 after the strangulated hernia op).

Thanks again to everyone for being supportive!

Last edited by dianajune; 10-28-2011 at 04:42 PM.

 
Old 10-28-2011, 08:00 PM   #12
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Re: Inadequate pain relief after emergency surgery..help!

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Originally Posted by dianajune View Post
My post-op visit went well, but my staples and JP drain will have to remain in place until at least Wednesday. My surgeon couldn't absolutely promise they'll come out then, but he was optimistic about it. Re. the pain, it has improved, but Vicodin doesn't do much except that I feel stoned!


I'm glad that your post op visit went well. That's good news. I'm sorry though that the drains and staples didn't come out. I hated mine after my two back surgeries, so I understand they are awful to have there.

Don't worry about your comment re. my pain. I didn't take it as being snide! As for the Vicodin, they want me to remain on it and he wrote another prescription just in case. He was very nice about our differences re. meds, but I doubt I'll get another refill. Re. the nausea, I think it's the Flagyl that's upsetting my stomach for the most part (or maybe the other anbiotic too). I can eat, brush my teeth and take mints and still taste that Flagyl several hours after having it! Yuck! heheheee
It could very well be the Flagyl that is causing the stomach upset, and with the tylenol, it might be making it worse than it would be without the antibiotic. I haven't taken that particular antibiotic in some time so I forget how awfully hard it can be on the stomach and tastebuds.

The drainage has lessened quite a bit, so I guess that's a good sign. I had to go to the store to get groceries and another prescription (not surgical-related) and did laundry. I had help, praise God! Dad took me to my appointment and lifted everything for me. The wound around my last JP drain seemed to leak more, but I think it was from the running around today. I'll try to not overdo it next time I go out.
I'm glad that the drainage has eased too. It seems that you are doing really well considering your surgery and now are on the road to a real recovery. I will keep my fingers crossed it stays this way for you. I'll bet it felt good to be out and about today, even with the increased drainage for a time. It should slow back down.

The surgeon said my incision looks good, and it's not leaking any yellow fluid at all. It did for several days but appears to have stopped. However, I have a bump near my belly button and I'm hoping it's not more fluid collecting. That's what happened last time I had stomach surgery and would hate to have to keep this drain in place or find I have another infected seroma (like I did in '09 after the strangulated hernia op).

Thanks again to everyone for being supportive!
It sounds like a really good first post op appointment. Some surgeons only have a certain group of meds that they use consistently post op and it sounds like this surgeon may be one of those doctors. Usually it is because they feel the group of meds , together give better results all around so they tend to not want to change things around. Anyway, thanks for the update and I'm glad that things went relatively well today. Next Wednesday, we'll hope the drain comes out and the staples.

 
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Old 10-28-2011, 08:14 PM   #13
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Re: Inadequate pain relief after emergency surgery..help!

dianajune, I'm glad your appointment well today. I agree with Backhurta that docs, especially surgeons, like to prescribe the same thing. Just an FYI, if your nausea keeps bothering you, there is Zofran ODT which stands for orally disintegrating tablets. You put in your cheek and it dissolves within 5 minutes max. This med has been a life daver for me. I am on chemo and use 2 different meds for nausea, phenergan and then if that does not work or I am vomiting, I go to the Zofran ODT. It has stopped me from puking every single time!

Again, glad things went well and hope on Wed. they can remove the drain!

 
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Old 10-29-2011, 09:15 AM   #14
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Re: Inadequate pain relief after emergency surgery..help!

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Originally Posted by backhurtz View Post
It sounds like a really good first post op appointment. Some surgeons only have a certain group of meds that they use consistently post op and it sounds like this surgeon may be one of those doctors. Usually it is because they feel the group of meds , together give better results all around so they tend to not want to change things around. Anyway, thanks for the update and I'm glad that things went relatively well today. Next Wednesday, we'll hope the drain comes out and the staples.
The appt went very well, I must admit. Re. the meds - I'll be done with the antibiotics on Monday. I'm not sure if I will get the other prescription of Vicodin. I'm getting a little better each day and am able to get around a little more. Yesterday I overdid it, though.

Today my drain is practically empty. Hopefully it will remain that way!

 
Old 10-29-2011, 09:21 AM   #15
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Re: Inadequate pain relief after emergency surgery..help!

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Originally Posted by Boxerluver View Post
dianajune, I'm glad your appointment well today. I agree with Backhurta that docs, especially surgeons, like to prescribe the same thing. Just an FYI, if your nausea keeps bothering you, there is Zofran ODT which stands for orally disintegrating tablets. You put in your cheek and it dissolves within 5 minutes max. This med has been a life daver for me. I am on chemo and use 2 different meds for nausea, phenergan and then if that does not work or I am vomiting, I go to the Zofran ODT. It has stopped me from puking every single time!

Again, glad things went well and hope on Wed. they can remove the drain!
Boxer: I will keep you in my prayers. I didn't have to go through chemo when I was diagnosed with the borderline ovarian cancer 7 years ago but had to have a total abdominal hysterectomy. I can't imagine how hard it is for you! <hugs>

Re. the Zofran, I think they gave it to me in the hospital. Are you saying it's available over the counter? What I try to do whenever taking the antibiotics - esp. the Flagyl - is to munch on at least a couple of crackers to keep the nausea at bay. Sometimes I have to have more than that if the bad taste of that medication persists.

I wonder why they don't flavor all these pills? You know, like Flintstone chewables??

 
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