It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



TMJ Disorder -TemporoMandibular Joint Message Board
Post New Thread   Reply Reply
LinkBack Thread Tools
Old 06-05-2012, 12:09 AM   #1
Junior Member
(female)
 
Join Date: Jun 2012
Location: Qld, Australia
Posts: 13
Jay32 HB User
acute TMJ

Hi all
I am female, 44 and all of a sudden I have developed acute TMJ disorder. For 6-7 years I have been experiencing constant painless popping and clicking in my jaw, when I eat or open my mouth wide. I have an overbite which I thought was why my jaw clicked so much. Suddenly the clicking became very loud & sticky, then 3 days later, my jaw locked. I can no longer open my mouth very wide and can hardly fit 1-2 fingers inside my mouth. Brushing my teeth & eating has been a nightmare.
I am terrified as no one seems to understand or know how to treat this condition.
I am going to see a TMJ specialist who have advised I require a repositioning splint which I will need to wear 24/7 until my jaw muscles relax.
I am frightened to spend this money $6000 australian dollars, for something that may not even work.
Pls help or talk to me
Miserable & in pain
Jay

Last edited by Jay32; 06-06-2012 at 10:47 PM.

 
Reply With Quote
The following user gives a hug of support to Jay32:
judye (06-05-2012)
Old 06-05-2012, 02:26 PM   #2
Inactive
(female)
 
Join Date: Jun 2011
Posts: 59
judye HB Userjudye HB Userjudye HB Userjudye HB Userjudye HB User
Re: acute TMJ

Hi Jay32,

Just wanted to give you a quick note of encouragement...

I was hit by TMJD like a ton of bricks three years ago - had to leave work and was pretty much mired in pain, bed-bound, for the first two years as I struggled first to get a diagnosis and then to find a NM dentist who whose treatment would be effective.

I finally found and excellent NM dentist (who had successfully treated others with TMJ, including himself!) and went into splint therapy (lower, repositioning splint worn 24/7) one year ago. I'll be honest - things got a bit worse before they got better - but after 4-5 months, I finally felt relief from pain and extreme symptoms - felt better than I had in years! I stayed in splint therapy longer than most, almost one year, and went into phase two (braces/functional orthodontics) one month ago. The first month of braces is a bit of an adjustment but things are still going really well with only small ups and down as I continue to heal.

I hear you - it is very scary to be diagnosed with something as painful as TMJ only to find that there is not a lot of understanding among specialists about it. In fact, there are no standard practices in this field - TMJ specialists even disagree about what the best treatment is. It's so sad that so many people have worsened their TMJ by getting the wrong treatments, by an inexperienced dentist, or because they can't afford the right ones. Surgery is the only thing that is covered and it has a shockingly low success rate. I spent almost a year with a traditional NM dentist, and a ton of money, on treatments that didn't help me in the least. It is really an outrage that there is still no coverage for the most effective treatment, particlarly for misaligned bite or malocclusion, which is functional orthotic (splint) followed by functional orthodontics (braces).

The good news is that you seem to have arrived here pretty quickly after your diagnosis, so you can start the process of recovery fairly soon. The one thing I'd suggest is not to rush - make sure you are with an excellent modern NM dentist, one who has done a ton of post grad work with regard to treating TMJ and who has had success treating others with this problem. I've seen posts of people paying for splints that don't end up helping them because they are the wrong type or the dentist doesn't really know their stuff. It's a super tricky (and expensive) thing to treat, so make sure you've got the best dentist on your side and travel if necessary to find one.

Generally, the splint process is used to relax your muscles and find the optimal position for your bite. Once that position is found, your symptoms are greatly reduced and so you know that it's working. Then comes phase two - functional orthodontics (braces), which are used to permanently shift your bite into this position.

In the meantime there is a lot of things you can do. I don't want to overwhelm you with a barrage of info but if you'd like to know about some of the key things myself (and many others on this site) have found useful, I'm happy to share.

The one thing I would suggest really soon is getting yourself to a physiotherapist who specializes in orofacial/tmj issues. A regular PT won't do much and may end up hurting you. The TMJ PT can help you address postural issues (a huge contributor to pain/symptoms), muscular tightness, exercises to relax muscles, ease jaw and open up your bite, and help with pain relief (things you can do to really help like moist heat, etc.) You may consider finding a PT who does TMJ trigger point release - many have found this helpful during splint therapy.

I also saw an acupuncturist who knew how to treat TMJD (I tried general acupuncture first and it didn't help at all) and he gave me specific treatment for lock jaw, which really helped me.

Just want to say that things can get better and it sounds like you are on the right path! I know it's a ton of money to spend and it should be covered...but it's your body and there is no investment more important than a life of good health.

Wish you the best in your recovery...try to remember there are people like me (and others on this site) who have been where you are and have found the path back to health.

Hang in there

 
Reply With Quote
The Following User Says Thank You to judye For This Useful Post:
Jay32 (06-06-2012)
Sponsors Lightbulb
   
Old 06-06-2012, 10:50 PM   #3
Junior Member
(female)
 
Join Date: Jun 2012
Location: Qld, Australia
Posts: 13
Jay32 HB User
Re: acute TMJ

Thank you so much for your reply. I cannot believe how much better I felt knowing I am not alone in this world with this bizzarre condition.
Thank you for your words of encouragement. Truly appreciated.
Will keep in touch
Jay

 
Reply With Quote
Old 06-15-2012, 06:14 PM   #4
Inactive
(female)
 
Join Date: Jun 2011
Posts: 59
judye HB Userjudye HB Userjudye HB Userjudye HB Userjudye HB User
Re: acute TMJ

Hia Jay,

I'm so glad. It's tough enough dealing with this wacko condition - it's important to have support. I've always found there is a certain comfort in knowing someone else knows what you're experiencing through shared experience.

Just wanted to remind you that 2/3 of the entire jaw repositioning from phase one (braces) and phase two (orthodontics) occurs in in phase one, so it's normal to have some growing pains. Don't be disheartened if you don't feel immediately better. It's quite normal to take 4-6 months before you start to feel relief. For some lucky folks, it's earlier...let's hope that's the case for you.

Also, don't be shy to go to your nm dentist whenever the splint feels out of balance and needs adjustment. I had to go many times and this really helped us to find the optimal bite position more quickly. I went in a lot more than most but was shy to go as often as I needed - I think if I went in even more frequently, I would have found relief sooner. Some dentists make appointments for you every 2 months and this is way too long. Many like mine will see you as soon as you call and feel that you need adjustment. I think this is proper procedure because you can immediately follow the cues your jaw is giving you to find the best bite and keep discomfort at bay.

I'm pulling for you! Don't feel shy to say hi if you ever have any questions or need a little support.

Last edited by Administrator; 07-14-2012 at 03:29 AM.

 
Reply With Quote
Old 06-21-2012, 02:33 AM   #5
Junior Member
(female)
 
Join Date: Jun 2012
Location: Qld, Australia
Posts: 13
Jay32 HB User
Re: acute TMJ

Hi again, I'm getting my splint next week and can't wait. I am wearing a temporary one my NM dentist made me from the bite template that he took. It's big & bulky & looks like ugly blue tac in my mouth, but I feel relief when I wear it. I still can't open my mouth very far, but I notice when I take it out (due to going out in public etc), and I talk & socialise, I ache so much.

So Im hoping this splint will keep giving me ongoing relief. I just wanted to ask you "how will you know when or if, I will need an adjustment?" Can you explain what symptoms to look out for? How does the NM dentist adjust it?

Can you also let me know how did you adjust when you started wearing the splint 24/7? Could you speak properly, did it hurt?

Thanks again for all your wonderful advice & support.
Jay

 
Reply With Quote
Old 06-21-2012, 06:13 AM   #6
Inactive
(female)
 
Join Date: Jun 2011
Posts: 59
judye HB Userjudye HB Userjudye HB Userjudye HB Userjudye HB User
Re: acute TMJ

Hi again Jay,

Really happy to help - I know how scary all this can be and how difficult it is to feel safe without a whole lot of information out there on this process.

Congrats on getting your splint! I'm really hopeful for you. I think it's a great sign that you are already feeling relief when you wear the temporary one (and notice distress when you remove it). Hopefully you will find quick relief once you get the permanent repositioning splint - some people do. Remember that as your jaw starts to move, it's pretty normal to experience some growing pains as well.

When I first got my splint, I did lisp for the first couple days. My husband thought this was cute but I didn't think so! I used to have a lisp as a child and trained hard to get rid of it in the first place! I also couldn't eat very easily. To be honest, I had trouble adjusting to it in general. It felt like a foreign intrusion in my mouth, very unnatural, and I panicked a bit over its permanence. I worried that the process wouldn't work as my body seemed to want to reject it. After two or three weeks, this died down and after a few weeks it started to feel natural and normal to me. No one could tell anything was different about me in any way. It looked so natural that people couldn't tell there was a anything going on in my mouth.

Did it hurt? Before I answer this one, Jay please keep in mind that I had pretty severe TMJD and I have central sensitization, so I'm not the average case. Things got worse for me before they got better. The first while in the spint was pretty rough actually. My muscles were super tight (off the charts according to my dentist's tensing machines) and it took them a while to start to relax. Also, apparently 2/3 of the change that happens in the whole splint/braces therapy happens in phase one. So that's a lot of moving around! I bought an ULF tens machine which helped the muscles relax. You might ask your dentist if they have a home version ultra low frequency tens machine to lend out (most the good dentists over here do this) as this may help you. Applying moist heat really helped too.

In terms of adjustments - most dentists use tens to relax the muscles and K7 jaw tracking machines to do major measurments and adjustments. This is generally a starting point as the dentist needs to use their own expertise, along with cues from your mouth, on how to adjust as well. Some people on this forum only receive k7 jaw tracking adjustments - their dentists seem to rely solely on the machine. Mine did tons of adjustments in between the major visits where you hooked me up to tens and K7 and I believe good dentists will do this.

You ask a really hard question about how to know when you need adjustment. I'm hesitant to answer because I think the signs will be different for each person. Usually your symptoms will worsen but it's possible you may experience a new symptom. Expect to be confused at first. Things take a while to get used to but after a while you'll get into the rhythm of it. Pay attention to how it feels when you have relief and know that experience. Expect to be uncomfortable immediately following adjustments but things should ease off. If things have eased off for a while, then get worse, you probably need an adjustment. Listen to your body carefully, it will steer you in the right direction. If I never hit the ease period after an adjustment or if I hit it then lost it, I saw my dentist. He saw me many times between the scheduled major adjustment for fine tuning. During these intermediary visits, sometimes tensing and sometimes not, and no K7. My dentist would look for a certain fit, certain teeth touching etc and would modify the orthotic slightly - sometime up to 15 times in one visit as we tried to achieve the right fit. He relied on my cues. After each modification, I'd sit up (you can't tell if it's in the right position lying down) and give him feedback. He'd modify again. Usually we'd go like this 10 to 15 times in order to get it right. Quite the ab workout. I'm really shy to put people out, so I had to try to get over this in order to get the best treatment...Don't let being polite get in the way of your good health. Get as many adjustments as you feel you need and when you are in the office, get him to make micro-modifications until you are as comfortable as possible. He'll need your feedback to do this properly so learn to listen to your body and try to be really aware and well-slept when you go in to your appointment.

On another note, my dentist co-treats with a TMJ specialty chiro and my splint therapy wasn't successful until I straightened out the misalignment in the body and neck. I needed to go weekly for a while to get myself straight but this was a key for me in recovery. Not everyone's body/neck is involved in their jaw misalignment but many people's are. Something for you to keep in mind if things aren't moving forward.

I am pulling for you Jay - and excited that you are getting your splint. One step closer to healing! Let me know how it goes

Last edited by Administrator; 07-14-2012 at 03:30 AM.

 
Reply With Quote
Old 06-21-2012, 11:58 PM   #7
Junior Member
(female)
 
Join Date: Oct 2011
Posts: 47
Blog Entries: 1
MissyJ HB UserMissyJ HB User
Re: acute TMJ

Quote:
Originally Posted by Jay32 View Post
Hi again, I'm getting my splint next week and can't wait. I am wearing a temporary one my NM dentist made me from the bite template that he took. It's big & bulky & looks like ugly blue tac in my mouth, but I feel relief when I wear it. I still can't open my mouth very far, but I notice when I take it out (due to going out in public etc), and I talk & socialise, I ache so much.

So Im hoping this splint will keep giving me ongoing relief. I just wanted to ask you "how will you know when or if, I will need an adjustment?" Can you explain what symptoms to look out for? How does the NM dentist adjust it?

Can you also let me know how did you adjust when you started wearing the splint 24/7? Could you speak properly, did it hurt?

Thanks again for all your wonderful advice & support.
Jay
Hi Jay,

Glad that you're finding some relief with the temporary splint!

I've been wearing my orthotic for about two months now. I don't have any succes story to tell because I'm still not really finding much relief, but I can share my experience about how things were when I first started wearing it. I'll try and answer some of your questions.

- How did you adjust when you started wearing the splint 24/7?

I couldn't eat properly with the orthotic the first few days. I remember my first meal with it was some really soft and thin noodles that didn't really require much chewing, and I still found it really weird and I couldn't really eat it properly. It got better about a week after. Now, two months later, I have no problem eating with at all. It feels just like eating with normal teeth, and sometimes I have to remind myself to go easy on the chewing as I'm worried I might break it.

For the speaking part, the first few days were totally strange as well. There was a small gap in the front of the orthotic, which made me have a lisp. I couldn't pronounce my 's' sounds well. I went back for my first adjustment about a month after receiving my orthotic, and my dentist added some material to the front and so the gap wasn't so big. Now, two months later, I can't say I speak the same as without the orthotic because I still pronounce some sounds weird at times, but it's gotten a lot better.

Also, just wanted to add that for me there were lots of muscle spasms going on the first month or so. Especially the first four days, those spasms were pretty crazy.

- How will you know when or if, I will need an adjustment?

So far I've been back for two adjustments. I don't really 'know' when I need an adjustment, but I'm just following my dentist's advice: after receiving the orthotic, go back once a month for the next three months for a follow up and adjustment. However, I've read on the forum that some people may go back the next day, or the next week, or as often as they want. So how often and when you go for the adjustments would really depend on you and/or your dentist.

- How does the NM dentist adjust it?

I'm not a professional so I don't know proper dentistry terms, but I'll try and explain my experience in plain words. An adjustment is when the dentist trims the orthotic with a dental mill. How does the dentist know where to trim? I was first put on the TENS for an hour, after that while still hooked on the TENS and wearing my orthotic, I made involuntary taps onto coloured paper (sorry I don't know the proper name for this paper) that he put in my mouth. This then made coloured spots on the orthotic. You take the orthotic out, and your dentist can see the spots on it, and he can then trim (adjust) the orthotic accordingly. There was lot of 'slide your jaw to the front/left/right', 'relax your jaw', 'tap tap', 'take it out', 'put it back in' etc.

I hope the treatment works out for you! Do let us know how it goes! Take care.

 
Reply With Quote
Old 06-27-2012, 02:17 AM   #8
Junior Member
(female)
 
Join Date: Jun 2012
Location: Qld, Australia
Posts: 13
Jay32 HB User
Re: acute TMJ

Thank you so much for your reply. Lots of advice you gave and explained a lot of stuff that I'm just newly going through. I will certainly keep in touch. Is your splint worn on bottom teeth only? And can you open your mouth very wide?
Thank you
Jay

 
Reply With Quote
Old 06-27-2012, 05:40 PM   #9
Junior Member
(female)
 
Join Date: Oct 2011
Posts: 47
Blog Entries: 1
MissyJ HB UserMissyJ HB User
Re: acute TMJ

Hi Jay,

My orthotic is worn on the bottom and it covers all my lower teeth. And yes I can open my mouth very wide if I want to but I generally try not to do that too much.
All the best!

 
Reply With Quote
Old 06-30-2012, 05:37 PM   #10
Junior Member
(female)
 
Join Date: Jun 2012
Location: Qld, Australia
Posts: 13
Jay32 HB User
Re: acute TMJ

Bring on Tues 3rd July for my splint. I am nervous but glad at same time.

Do you take it out to brush your teeth? I was told I could take the splint out to brush, be very careful not to bite down, then put it straight back in again.

Also when you were in the severe stages of TMJ, was your jaw locked? I still have limited mouth opening and it hurts to chew anything that is a tiny bit tough or crunchy. I avoid all that food, but how I long for a burger or steak lol.

Do you have much opening power of your mouth?

Thanks again

Last edited by Administrator; 07-14-2012 at 03:31 AM.

 
Reply With Quote
Old 06-30-2012, 07:17 PM   #11
Facilitator
(female)
 
MountainReader's Avatar
 
Join Date: May 2006
Location: Out West
Posts: 3,695
MountainReader HB UserMountainReader HB UserMountainReader HB UserMountainReader HB UserMountainReader HB UserMountainReader HB UserMountainReader HB UserMountainReader HB UserMountainReader HB UserMountainReader HB UserMountainReader HB User
Re: acute TMJ

I've had my lower mandibular repositioning splint for two years now.

My speech was off for a while, but it got pretty much back to normal fairly quickly. The dental office told me to practice reading aloud to help with the speech. It really will probably depend on the kind of splint you end up with. In my case, it completely covers all of my lower teeth, which not all splints do. The result for me was having less room for my tongue behind my lower teeth. Sounds like my "s's" were off until I adapted.

I don't remember any difficulty adjusting to the actual fit of my splint. It took me a few visits to get the "bite" right. A few times they would make adjustments and it felt right in the office, but as I wore it I found it wasn't quite there. Once I did get it right, I don't remember any real problems. I just need periodic "tweaks" as my bite changes.

When you get the splint, they have you bite down on some paper with black or red on it. They have you bite up and down, move side to side, tap, etc... When they pull the paper out, if you have something off, there will be black or red mark on your splint. They will make minor adjustments to that mark until you have a good fit.

The main problem I have with chewing is when I eat things that the acrylic can't get through. Lettuce, pickles with the "skin", skins on uncooked peppers, things like that that are flat and need the sharpness of the teeth are the hardest for me. Most cooked things are just fine though.

They should give you instructions for your splint care. I brush my splint every time I brush my teeth. Also, once a day I soak it in with one of those denture tablets to help with the germs. I've found that soaking while I shower it is easy to make that part of my routine.

Most people with TMJD have muscles in almost constant spasm. Eventually the splint should help your muscles relax as they get used to the new positioning. I HIGHLY recommend that you get some therapy in conjunction with the new splint. A good craniosacral therapist can help. I found a good PT who was trained to do orofacial trigger point releases. Those releases on my masseter and pterygoid muscles were very painful, but each visit they got easier and easier. She also worked on my neck as well since the TMJ tightness extended down that far.

Good luck.
__________________
Asthma, Allergies, severe LPR/GERD, TMJD, Hearing Loss, Ulnar Impaction Syndrome, Shoulder Impingement, Plantar Fasciitis, DeQuervains, Hypermobility, possible Ehlers Danlos Syndrome

 
Reply With Quote
Old 07-01-2012, 06:05 PM   #12
Inactive
(female)
 
Join Date: Jun 2011
Posts: 59
judye HB Userjudye HB Userjudye HB Userjudye HB Userjudye HB User
Re: acute TMJ

Hia Jay,

Glad to hear things are moving forward - it's a big step, but a good one. I hope it all goes well and it doesn't take too long for you to adjust.

How nice that you can brush your teeth! My splint was not removeable so that wasn't a possibility for me. I went nearly a year with my teeth unbrushed, gums unflossed - so very gross!

My jaw never technically locked when things were bad but I definitely had a restricted opening (20 odd millimeters), so just about two fingers. The TMJ PT I saw really helped with this through. I did daily exercises that helped too. It hurt so much to try to open my mouth wide and I always had a lot of pain after dental visits due to trying to open my mouth wide. I think it was this very thing, during a long and painful routine, that actually started the full blown TMJ picture for me.

I still have some restriction and it's still painful after dental visits. I know I have a lot of trigger points in my face but I've held off getting trigger point therapy as I have central sensitization and even gently touching these trigger points causes pain. Chewing has been very difficult for me. I was on a soft food diet for over a year! I still can't bite down on hard things but it's gotten a lot better. So nice to eat fairly normally (by the end of my orthotic treatment). And then of course now, I'm eating with braces - so no steaks again! Grrrrr.

I'd really recommend getting a great PT who specializes in TMJ/orofacial issues. This will help you deal with pain, improve your opening and undo trigger points as you move toward a healthy position through your splint. I'd avoid going to a regular PT though - this didn't help me at all, but made things worse as they didn't really understand what they were dealing with.

I'm pulling for you Jay...you hang in there! You WILL eat hamburgers and steaks again!

Let us know how it goes

Last edited by Administrator; 07-14-2012 at 03:31 AM.

 
Reply With Quote
Old 07-03-2012, 01:14 AM   #13
Junior Member
(female)
 
Join Date: Jun 2012
Location: Qld, Australia
Posts: 13
Jay32 HB User
Re: acute TMJ

Hi
Thanks again for your wonderful advice. I need a little email hug or pep talk. I am 7 hours into wearing my new splint. I hate it, and I feel like I am going to constantly gag all the time. I tried my first meal, pasta, and it was a horrible experience. This hard piece of plastic locked tight in my mouth feels so foreign to me. I feel like I cannot chew and when I do, it feels like rocks between my teeth.

I am panicking a little but refuse to take it out, as it is early days. It all feels too weird. I am scared & sad.

Last edited by Jay32; 07-04-2012 at 03:58 PM.

 
Reply With Quote
The following user gives a hug of support to Jay32:
judye (07-03-2012)
Old 07-03-2012, 08:57 AM   #14
Inactive
(female)
 
Join Date: Jun 2011
Posts: 59
judye HB Userjudye HB Userjudye HB Userjudye HB Userjudye HB User
Re: acute TMJ

Hi Jay,

It's very freaky when the splint first goes in. I really panicked as well. Had trouble eating, speaking and it just felt like this awful foreign intrusion in my mouth. In a way I'm glad mine didn't come out because I would have been tempted to take it out for sure! I really worried that my body would totally reject it and we'd have to take it out and end splint therapy. It's so intrusive and unnatural at first. Then, over time, I got used to it. Eventually it felt natural and normal and eating became easier.

The first day was the worst because I had to let it settle in my mouth before the dentist created proper tooth grooves - it was left pretty flat at first. The second appointment after getting the splint was when he molded it better to my mouth, creating a better bite. I then went in for a few more appointments to perfect the bite. But after the first appointment, there was virtually no bite! It's an awful feeling.

It will get better Jay! Your body is just reacting normally to a weird intrusion, but you will adapt and it should get much easier.

Hang in there!

Last edited by Administrator; 07-14-2012 at 03:31 AM.

 
Reply With Quote
Old 07-06-2012, 11:37 PM   #15
Junior Member
(female)
 
Join Date: Jun 2012
Location: Qld, Australia
Posts: 13
Jay32 HB User
Re: acute TMJ

Four precious days into lower splint therapy. Apart from tears, adult temper tantrums lol and learing to eat and sleep with splint, I thought I'd share my early symptoms.

I have been sadly struggling with re-occuring jaw pain. My jaw starting aching in the 2nd day after splint was inserted and I also had re-occuring shooting sharp ear pain.

Each day has been a challenge, but I'm pleased to say that on day 4, my jaw muscles have stopped aching so much, that I didn't use a heat pack and take meds today yay!

I still am having difficulty eating with splint, but I know I will get there.

My case is a closed lock with 2cm opening. I guess any improvement over time would put a huge smile on my dial

Looking for other success stories that enabled less pain and more jaw opening!

Pls share xo

Last edited by Jay32; 07-06-2012 at 11:38 PM.

 
Reply With Quote
Reply Reply




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Join Our Newsletter

Stay healthy through tips curated by our health experts.

Whoops,

There was a problem adding your email Try again

Thank You

Your email has been added




Top 10 Drugs Discussed on this Board.
(Go to DrugTalk.com for complete list)
Botox
Flexeril
Ibuprofen
Klonopin Motrin
  Neurontin
Tylenol
Valium
Vioxx
Xanax




TOP THANKED CONTRIBUTORS



MountainReader (78), Canuck65 (37), Shirlett (26), TMJ82 (22), Jill 227 (17), judye (16), Marlene (13), navymid (10), clencher1 (9), saltyk9 (8)

Site Wide Totals

teteri66 (1180), MSJayhawk (1009), Apollo123 (909), Titchou (856), janewhite1 (823), Gabriel (760), ladybud (755), midwest1 (669), sammy64 (668), BlueSkies14 (607)



All times are GMT -7. The time now is 10:42 PM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!