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Old 02-18-2005, 11:29 PM   #1
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Exclamation C5-6 and C4-5 real bad C3-4 and C6-7 not good - I need help

I have had neck pain for 10 years, but in the last 3 years it has been gradually getting worse and worse. I have a high pain tolerance and I am in extreme pain, even though I am on Duragesic 50 MCL and 10 MG Norco (Hydrocodone) for spikes.

3 Years ago, I finally went to a Neurologist at my Primary Doctors request. I had a good bit of pain, but I am able to tolerate more pain then the usual person. He ordered the first MRI. When He called me in for the results, he just shook his head and said 'this is the worse case I have seen in a man your age (40 at the time). That said allot and right away I knew I was in trouble. Basically 4 bad discs 1 severely broadbase with cord stenosis and nerve stenosis on the C5-6. The C4-5 was medium base and the other 2 C3-4 and C6-7 were mild at the time. But my nerve pain was starting to get were I could not stand it, so i asked for help. He recommended PT and Darvecet. Neither worked and I progressed to a home traction machine. My condition continued to decline and Pain got worse. After all kinds of therapy and treatments that did not work, In 2004 he ordered and new MRI. It showed that the C5-6 and C4-5 got worse, as my pain diagnosed before I got the MRI. I was up to 25 lbs on the traction machine. The Neurologist recommended I stop the traction and got to Pain Management, since I was not going to have fusion with 4 bad discs.
When the Pain Management Doctor looked at my MRI's, he's said that traction could have actually made my problem worse because I have annular tears in my disc that fluid is leaking out. The traction may have stretched the discs so the tears got bigger and leaked out further. He recommended Epidural injections. I was in enough pain at that point, I said do it.
I think I would have done about anything that had a chance of helping, because the pain level was so high. Remember, I can handle pain, Played football as a QB with fractured ribs once. I had torn ACL, broken ribs and other painful ailments and did not phase me much (or I hided it very well).
I went through 3 of those Cervical Epidurals with very little relief for about 3 weeks. Then it got worse again. So He recommended the Facet Blocks. I had 2 of them. after the second one it gave me about 60% relief on my right side for 1 day.
Then the pain came back full force. So the Pain Management recommended Radio Frequency Ablation, because the facet block work for a short time and he thought he could burn that nerve and relieve the pain. I had that done the first week of January 2005. After the Surgery I had quite a bit of increase in pain and now, 6 weeks later, I am really hurting.
I went back last week to see the pain management PA. I told him of my increase in pain, so much so that I passed out. I said I need more pain meds to handle life (I am working from home and want to continue to work). He was very short and in an angry voice said I should have went to the emergency room when I passed out. I said I was home alone and the pain had slowed, so why take the chance of passing out behind the wheel of my car .Duh. So he said We need an MRI right away to be sure the RFA procedure did not create additional problems. I was in extreme pain in the office and asked him to increase my pain meds so I can work and take a shower. He left the room to talk to a surgeon. When He came back he gave me a prescription for the same pain meds I was currently on (25 MCL Duragesic and up to 4 Norco a day in which I had to take all 4 every day, so I still had no pain spike meds). I said to the PA 'You are going to let me leave this office today in severe pain and leave me like this, suffering'. He said 'Yes.. the Doctors will not increase my pain meds since there are so many law suits and we treat pain with procedures not meds'. I WAS SO ANGRY!!!
I called my Primary and complained big time and he said If I wanted to drop the Pain Doc that he would handle my pain meds until he could find somebody who does that. In the mean time I have to take 5 or 6 Norco to get close to managing regular life. This is on top of the 25 Duragesic (Fetynal).
I had the MRI done and had it sent to my Neurologist and the Pain Doc. This week I got a call from the Pain Doc to come in. The MRI Results are alot worse, since 3 years ago they said. They suddenly changed they're minds and increase my pain med to 50 MCL Duragesic from 25 and 1 Hydrocodone a day for spikes. It is not cutting it. I am in severe pain still. I am also wondering why the had a change of heart and want to treat me with pain meds now. Could it be the MRI showed something went wrong with the last procedure and they are worried? I don't know, but I have all my films. I don't want to sue anybody, unless they make me worse and I have to suffer. Then I may need the money later in life.
But for whatever reason they are saying they will treat my pain with meds all of the sudden. I'm deciding whether to drop them anyway and ask my primary to give me the pain meds, since the Pain Management PA and Doctor are not helping enough and I am still suffering. The pain is all the way down my right arm to my hands, down the left side shoulder and up and down my spine from the top of my back to my head, The pain is worse on my right side neck and shoulder. The Headaches can get really bad, as well. Why are they so scared to give pain meds? I would sign anything to show I won't sue if they are worried about that. The pain is worse than any pain medicine addiction. I had a couple doctors tell me that and believe it.
I am going to see a Neurosurgeon, Highly recommended by my Primary and Neurologist. To see what options I have. I am really worried about fusion since I have 4 bad discs. But in the mean time I don't know who to see to get help with my pain. What I have is not cutting the pain nearly enough.
Also, should I be worried about the increase in pain after the RFA procedure and get a Lawyer. Is it smart to have a Lawyer to protect me from descimination on my job, as well?
Any input would be greatly appreciated.

The latest MRI report says the following (some I understand and other part I don't). Any help or advise would be greatly appreciated.

At C5-6 there is broad-based posterior disc/osteophyte complex, with mild deformity of the ventral cord. The canal is mildly stenotic. There is left greater than right foramina! stenosis due to uncovertebral spurring, best seen on axial image 15, impinging the left C6 nerve root and encroaching on the exiting right C6 nerve root.

At C4-5 the canal is borderline narrow. There is posterior disc/osteophyte, more pronounced on the left where there is
contact of the cord surface. This Is best seen on axial Image 11. There is mild biforaminal stenosis due to uncovertebral
lipping.

At C3-4 there Is mild posterior disc bulge, minimally separated from the cord surface. The canal is borderline narrow, in
part due to short posterior elements. There are mild zygapophyseal degenerative changes, but the- foramina remain open

At C6-7, there is posterior disc bulge, touching the cord without deformity, the canal is mildly stenotic. There is mild left
foraminal stenosis,

IMPRESSION:
1 At C5-6, there is mild canal stenosis. Posterior disc/osteophyte complex produces mild effacement of the ventral
cord. There is significant left greater than right foraminal narrowing, encroaching on the C6 nerve roots.
2- Mild stenosis at C6-7, with posterior disc bulge touching the cord surface without significant deformity.
5. Borderline canal stenosis^tC3-4-anqhC4-5-without cord-deformity.There is mild biforammat-nafTowing^t^4-57
4. Straightening of the mid to upper cervical lordosis, suggesting muscle spasm.


Thanks in advanced for you help

Last edited by sned2121; 02-19-2005 at 06:26 PM.

 
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Old 02-19-2005, 11:14 AM   #2
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misery HB User
Re: C5-6 and C4-5 real bad C3-4 and C6-7 not good - I need help

Hi, I can't help but I thought I'd let you know that you might want to post on the backproblems board and the pain management board for more help and answers.
Best of luck!

 
Old 02-19-2005, 06:34 PM   #3
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Re: C5-6 and C4-5 real bad C3-4 and C6-7 not good - I need help

Thanks Misery, I will post there as well.

 
Old 02-20-2005, 11:16 AM   #4
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Re: C5-6 and C4-5 real bad C3-4 and C6-7 not good - I need help

I completely understand what you are going through. I have broadbased stenosis myself. It is mild at levels above 3, moderate to severe at levels 4-6 and mild again at c7. Congential for me. I am 46 and also had collapsed, bulged disk at c5, a herniation with a fragment floating and forminal problems at the nerve roots in C5-6 and causing misalignment (spondy..) . Lots of oetephyte formation on the right side posterior at all the levels. I was in excruciating pain on a daily basis taking as many at 8 oxycodone and ibuprofens a day.

I tried what sounds like the same routine, rest, drugs, PT (and the traction made me worse also), and epidural which gave me relief but only for a week.

Ultimately I had ACDF C4-5, C5-6 in Dec 2004 and probably another level due in my future at C3 we are going to try to avoid it, and maybe by the time I have to do it more techniques will be available.

THe thing that worked the best for me before surgery was NEURONTIN 600mg 3-4times a day. By one month taking it I was able to get down to hydrocodone and only 3 -4 a day. Some days less. this helped me get through 5 months while waiting to decide to do my surgery.

There are some people who do not like NEURONTIN it can have side affects. My thinking was that I couldn't function dopped up on oxycodone and high pain, so I put up with what I would call minor side affects compared to the pain med stupor. I had minor issues with a little thick tonque, some mind dullness but was able to successfully work every day and I manage a 100 people. The NEURONTIN was key in controlling my nerve pain. I highly recommend it to others.

It sounds like you need surgery good luck, hopefullly you will feel better than you do now. I feel better, even though not 100% pain free, it is more like hurt than pain, quite a difference.

 
Old 02-20-2005, 01:16 PM   #5
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Re: C5-6 and C4-5 real bad C3-4 and C6-7 not good - I need help

Thanks for you advice aznativ.
The PM PA recommended that I try Neurotin, but it did not help me and I had some ugly side effects. But I may want to try it again later.
I don't think Neurotin will help me until I am given enough pain killers.
Isn't Neurotin a compliment to the pain killers?
My PM PA acts like he is doing me a favor when he increase my pain meds this week to Duragesic 50MCl and 1 Hydrocodone 7.5 mg (Loritad) and day. Big increase from 25 MCL Duragesic and 4 10 mg Hydrocodone (NORCO).
I feel almost exactly the same ..terrible.

I see my PCP on Wednesday and may be getting my Pain Meds from him and dropping the Pain Management.
I am in allot more pain since I joined Pain Management about 8 months ago.
I don't know if having all those procedures has anything to do with my worsening condition or it would have got worse anyway.

I want to hold off on Surgery, so I hope I can still function at my high tech job with whatever meds I move up to. But with the meds I have now, I can hardly stay at the computer for more than 1 hour, without needing a rest laying down. I am lucky that my job allows me to telecommute or I would already be on disability. I get dizzy and headaches, along with the pain, and need to rest throughout the day.

Good Luck to you and your surgery rehab. Please keep me informed of your progress.

Last edited by sned2121; 02-20-2005 at 01:18 PM.

 
Old 02-20-2005, 07:40 PM   #6
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Re: C5-6 and C4-5 real bad C3-4 and C6-7 not good - I need help

They aren't quite sure how the Neurontin works, it is a complement to the pain killers, but it isn't a narcotic. Taking Neurontin I was able to more than cut in half the amount of pain killers, drs. were happy bout that.

I think you are in the US. Drs. are freaked about pain meds because they are monitored by the FDA or whoever on how much they are prescribing and to who, some get investigated. If your doctor isn't helping you, find one that does, that's my advice. To tell you the truth I didn't like the Pain management guy who did my epidurals. He was like "I have seem people with much worse compression than you and not have surgery.. You can keep doing shots", I about bit his head off. They seem to get hardened to people. Of course he doesn't want to me get better, then he would lose out on the $4500 per epidural he was getting. Luckily my primary and my surgeon both had no problem giving me what I needed based on examining me and my history with them. They could see I was very sick.

I too am in high tech role. Here are hints I used to help computer. I actually had a couch brought into my office, brought in various pillows and telecommute like you when a rough day happened. Get a laptop moving away from sitting at the desk helped me, and the position was better for the arm pain.

On the more positive note about the doctors. They are right to be nervous about long term use of pain killers. We build tolerance, I certainly did and when I had surgery the anesthesiogist had to use lots of stuff. If something really bad happed it would take alot to knock the pain down so it is best to try to keep at a reasonable level. ONly for you it sounds like you are in bad pain still. IF you aren't having surgery you should investigate the other things available, like the implanted units that disrupt the signals etc. there are many options and trials going on.

 
Old 02-25-2005, 11:31 AM   #7
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Re: C5-6 and C4-5 real bad C3-4 and C6-7 not good - I need help

Has anybody tried rest for 2 or 3 months to help with neck problems?
My Doc suggested that I might want to go on short term diability to rest for my job for 2 or 3 months. I work on computers all day and this kind of work aggrevates my condition.
He said sometimes a couple months rest may help prolong the time before surgery is needed and the longer you wait for surgery, the better. If you don't have an immediate need for surgery, of course.
Also, He said in some people, it has helped in healing enough that surgery was not need for many years.

 
Old 03-10-2005, 11:07 PM   #8
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Re: C5-6 and C4-5 real bad C3-4 and C6-7 not good - I need help

sned,

for pain relief why not give IMT a try. this is very good for what you are having trouble with.

www.centerimt.com

This type of therapy is very gentle. It is the best I have found for what ails me, and I also have a high pain threshhold. When I broke my clavicle 16 years ago, I never saw a doctor, but I was in pain. Most pain subsides, but when it does not, it is time to try something new, like IMT.

I hope you are able to find a practitioner in your area. After the doctor patched me up from trigger finger with two cysts, carpal tunnel redo, and cubital tunnel which required transpositioning the ulnar nerve, I had immense pain and tremendous weakness. My arm was so weak it would wobble up and down just trying to bend it at the elbow. The swelling finally went away, the wobble is no longer a problem and I have regained much of the strength in that arm.

Two other patients I met were greatly helped from IMT, and these two people had c5 / 6 injuries. Both have regained most of their function and most of their sensation.

Eileen

 
Old 03-11-2005, 07:34 AM   #9
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Re: C5-6 and C4-5 real bad C3-4 and C6-7 not good - I need help

Sned 2121

I am so sorry to hear what is happening to you. Instead of me repeating myself if you read the thread or post to "Questions for Lyn in Michigan", it is the thread below yours, this is my story and a lot of it will sound very familiar to you. I am a 53 year old female and am also suffering from severe head, shoulder and neck pain. They are now telling me that they can't help me that I have "fibromyalgia or chronic myofascial pain"!!! I don't believe them, I think they are missing something. I also tried everything including traction and I don't think it made me worse but didn't help me. I had an Anterior Discectomy and Fusion with Titanium Plates and donor bone. They have just found out 14 months later that the second donor bone has disintegrated but they say the plate is stable and they don't want to operate again and they say nobody can help me. Well that isn't easy to live with!!! I had bone spurs, bulging discs and arthritis on C5/6/7 and degeneration and that is why they decided to operate but it didn't help (of course I had a whiplash car accident 6 weeks after surgery (not my fault) and that didn't help my pain. I am as frustrated as you so I hear you. I think it sounds like you need surgery but of course I am not a doctor (but could probably become one after all the research I have done)!!! Don't give up on your pain meds. if there is something out there that helps, I hope you find it.
I am thinking about you.
Take care
Lyn in Michigan

 
Old 03-11-2005, 08:43 PM   #10
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Re: C5-6 and C4-5 real bad C3-4 and C6-7 not good - I need help

Hi Lyn, I hope you feel better. It's now way to live life in pain all the time. I hope you surgery heals up nicely. Hopefully your own bone will generate to create it's own fusion. TYhat has happened in many cases. Good Luck.

Hi ecar, Thanks for the information on IMT. I will look into it. I want to try everything before I get surgery. It's a gamble either way as far as I am concerned. But it looks like I have time to think about it..see below

I talked to my first Neurosurgeon this week. He thinks the C5-6 definitelt and most likely the c4-5 will need fusion. He said it is not an emergency, at this point. Of course there is risk in waiting for the surgery, such as permenent damage to the nerves, the disk getting worse and pushing on the spinal cord and the risks associated with being on the Narcotics for pain. But he said he could not gurantee the surgery would help the pain. In fact many patient do not get releif from the pain. especially the more you need fused. Since I have the disk above and below the proposed fusions, I would have a greater chance of the domino effect on those disks with repeat surgeries sooner than a patient with good disks.
The good thing to me was e said it is not an emegency. It's not as if I can take a small tumble out of bed and make it allot worse. Unless I fall in exactly the right manner. I should be very careful driving.
So, I am going to wait for surgery and continue my Duragesic 75 patch (yes my PCP raised the level) and up to 4 Norco for breakthrough. It may go up as time goes on. But I am going to take my wife a go on a vacation for a week. We are going on a relaxing cruise. My PCP did not think it was a good idea, but I convinced him to see what the surgeon said and told him I bought the best insurance for cruises. I'm covered for $100,000 for medical evacuation and I have the pre-existing condition waier. Plus the Surgeon said go on the cruise, it may be good for your neck to get away from the computer.

We'll see how it goes when I get back. I hope to have a better work environment at my home provided mostly by my company to take the strain off the neck while working on the computer and teleconferencing.
hopefully this will allow my neck to rest and heal and hold off the surgery as long as possible. Maybe even prevent surgery forever Ok. that may be stretching it, but stanger things have happened.

Last edited by sned2121; 03-11-2005 at 08:51 PM.

 
Old 04-14-2005, 08:30 PM   #11
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necknose HB User
Re: C5-6 and C4-5 real bad C3-4 and C6-7 not good - I need help

Hi Sned:

Have you looked at ADR?

 
Old 04-15-2005, 04:03 PM   #12
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Re: C5-6 and C4-5 real bad C3-4 and C6-7 not good - I need help

Hi NeckNose,

I have not been to the board for a while. I have been busy trying to manage my job and this cervical spine problem.

I am not a candidate for ADR - Artificial Disc Replacement. They won't touch me with 4 bad cervical disks and 2 of them broadbased Herniated with annular tears (About as bad as they can get without needing immediate surgery).

After talking to 2 Neuosurgeons, my Neorologist and my PCP (who is a internal Medicine Specialist). I have determined that there is a better chance of surgury (Fusion of 2 of my Cervical disks) making my problem worse at this time, especially since the disks above and below the fusion are already showing signs on degeneration with herniation.
So I am going take meds to help with the pain. I am going to continue working as long as I can. My employer is going to send a professional consultant in ergononic office set ups for employees with disabilities to my home to work with me on an office configuration that will allow me to continue to work my computer job. It sounds like my employer will pay for anything I need. This was wonderful news to me.
I need to be reclined with neck while working on my computer, so it should be interesting the ideas we come up with.

Please let me know what ADR is. Maybe that is an option.

thanks

Last edited by sned2121; 04-15-2005 at 04:27 PM.

 
Old 04-15-2005, 05:32 PM   #13
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Thumbs up Re: C5-6 and C4-5 real bad C3-4 and C6-7 not good - I need help

Hi There sned ~

I can fully relate to your situation I am sorry to say. I am a 41 Y/O female and that is about the only real difference between our situations. Because of my spine problems I had to retire from being an EMT-I/Firefighter a few years ago now.

I will not be able to reply with everything in this one post because lumbar problems prevent me from sitting here that long.

I not only have cervical problems and surgeries... I also have lumbar and surgeries there as well. All of my troubles are not from an injury such as a fall or MVA.

Now to my cervical story if you want to call it and it will be a very short version to say the least. When I was about to have lumbar fusion I went for a discogram and while on the table the doctor who was doing the discogram asked me to lay my cheek (face that is) on the table. I couldn't because it was stiff and it hurt. It was agreed that both this doctor and I would talk to my NS about this. I did end up having a cervical MRI and found my cervical was as bad as yours.

So I had my 3rd surgery on my lumbar spine on 6/02. My first cervical surgery was on 12/02 C4-5, C5-6 ACDF with plate and screws. My 2nd cervical was on 6/04 of C6-7 where he took out the plate above (because C4-6 fused) and only had to put a plate and screws at C6-7. My 3rd cervical surgery was on 9/04 but this time it was posterior from C3-7.

I also suffered very bad headaches along with many other symptoms. I can explain more if you would like to know. Please ask. I am very pleased to say I am doing GREAT now!!!!

On May 3rd I will be having posterior lumbar surgery to add rods and screws with other work to clean stuff up and he could be adding another level there as well. I am fused at L4-5, L5-S1 and that surgery was anterior and done on 6/02.

I also want to read this whole thread and then maybe I will know more about you and what you are going through and what to share with you to try and help.

One more thing or two that I wanted to comment on. I am sure you are not one who will be able to have an ADR. If you go to Germany you might??? I will talk to you more on ADR if you would like. My NS does do ADR so I know some about it because we have talked about it. I will be able to tell you some about the RF you had and why you may be suffering with more pain now. Let me know.

That is about all I can sit for now so if you want to talk more or hear more about everything I went through with my cervical pre, post-op and the surgery or how I am now please feel free to ask any thing you want and I will be more then happy to share what I can with you.

Shirl
__________________
Love,
Shirl
History:

1980- Transaxillary resection of 1st rib and division of band (left side)
1982- Diagnostic Laparoscopy
1985- Transaxillary excision of cervical rib (right side)
1991- Laser stapedectomy (right side)
1992- Fractional D&C
1992- Diagnostic Laparoscopy
1996- Lumbar hemilaminectomy
1999- Left knee arthoscopic surgery
2001- Laparoscopic assisted vaginal hysterectomy
2002- L5-S1 Microdiscectomy
2002- L4-L5, L5-S1 Anterior inter-body lumbar fusion with cages and my own bone from left hip for bone graft
2002- Neck problems Surgery??????
2002 DEC 21- C4-5, C5-C6 Anterior Cervical Corpectomy with Fusion and Internal Fixation (Bone from the bone bank)

 
Old 04-16-2005, 09:32 PM   #14
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sned2121 HB User
Re: C5-6 and C4-5 real bad C3-4 and C6-7 not good - I need help

Hi EmtShirl,

It is great to hear a success story about multi level Cervical Fusion.
As you know the statistics show most multi-level cervical fusions are not successful or create more pain than before. That is one reason why I am trying to hold off on surgery as long as I can.
I also want and need to continue working.
I am the main money maker in my home and I provide all the benefits / insurances.

Can somebody tell me more about going on Long Term Disability. When you go on LTD Disability through your employer you get a percentage of your pay. I would get 60% of my salary.
What do most people do about Health Insurance?

I think I could use COBRA for a short time, but not the rest of my non-reirement years and it is very expensive, especially on only 60% of your salary. I imagine Private Health Insurance is very expensive with pre-existing spinal problems.

Does the Government give any tax breaks or help with medical?

Any input on this would be helpful, since I do noy know how long I can continue to work

 
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