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    Old 01-09-2008, 11:14 PM   #1
    XRoseTylerX
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    Help! In alot of pain, don't know where to go anymore

    I see a chiropractor who has been doing wonderful things for me through PT type exercises and tips for around the house. I don't have a PCP in this area, though I went back to my old one while visiting my parents 2 hours away, and got scripts for what I call my "every day meds" Ibuprofen (I tried Celebrex for a while and it didn't work) Robaxin (unless it's bad and close to bedtime, then I substitute Flexiril) and Tramadol, which my previous docs and I found kept me pretty normal and functional except for the post dinner aches and pains that just become unavoidable to people like us. He gave me 5 refills of each, and quite a few each time, so I'm stocked up.

    I just went for my first MRI on Saturday, and the tech pointed out two obvious bulges, at L 4-5 (which everyone assumed) and the one just above or below it (that one was a surprise.) and said though they were easy to see, they weren't "bad" as far as he had seen. The neuro, who saw me once briefly before ordering the MRI (wouldn't touch me until he had that thing!) hasn't gotten back to me yet.

    Since moving out of the military system and to this area of the civilian world (which was apparently the site of a rather large pharmaceutical and doctor type bust just months before we moved here) I haven't found a single sympathetic doctor. Mostly because I'm only 27, and also because I can't pinpoint the beginning of my pain. My first sciatic episode was 2 months after a car accident (where my whiplash was pretty bad) and I forgot all about it. It got really bad with my first pregnancy, after birth, and even worse with my second.

    I have what I call "flares" where for a few days, for no apparent reason, (or sometimes due to long drives, repeated motions etc) the sciatica and back aches get really bad. The sciatic stuff is what's awful. It can affect just one or both my hips, and I'm in the middle of one now. I went to the chiropractor, she said she couldn't do anything for me but recommend ice and NSAID'S and she wouldn't mess with my back tonight because she could feel the inflammation from the outside in a spot or two.

    So, I'm sure you know how it goes, the sciatica/low back flares up, then you start "guarding" as the Chiropractor calls it (oh, and the chiro comes highly recommended by the neuro) and before you know it your whole back is in a mess, you have a headache, etc. I'm having difficulty walking, even changing positions when lying down hurts, which is why I haven't been able to make it to bed yet.

    What do I do? I know from similar experiences in the past that this will last a few days, more than likely. Previously, I had a PCP who trusted me, and I could call him and he would script me for 20 7.5 hydros or something, and I would take them through the episode then not ask again for another 2-3 months. Should I call the neuro tomorrow? The MRI is there, so he does have proof that something is wrong. I'm just worried because when he saw me briefly before ordering the MRI, I felt great. I had just had a steroid injection (which is like a miracle drug for me.... I'm usually completely pain free after they take effect. Unfortunately, they end up wearing off after a week or so, and I can't get them that often) and told him so, that I didn't have much pain at all that day and I was doing fine. He said "Good." Then told me to go get the MRI and stick with the Chiro for my daily PM. Well, that's just fine for most stuff, but she can't write prescriptions!!! Plus the whole thing about the bulges on the MRI not looking "too bad" as the tech said.

    I just want this relentless ache in my hips and lower back to go away so I can sleep. I'm already maxed out on my Tramadol with no relief. Should I call the neuro tomorrow? Should I call the chiro to see if she (since they coordinate on patient care quite a bit) can contact him and back me up? All I want is a few prescription painkillers, and it seems like asking for them is a surefire way NOT to get them. I'm pretty much sure I'd be labeled as having "Drug seeking behavior" if I went in to an Urgent Care or ER because, well, I'm seeking pain relief. If you do call your docs, what do you tell them? Hey, I'm in alot of pain and until we can decide on my next course of treatment, I need a few drugs. Just for the next couple of days. What is the right thing to say when seeking pain relief not to get yourself "branded" and out of luck on getting help in the future? My severe pain is sporadically episodic like this. Comes on suddenly, last a few days, gradually goes away, leaving me with the daily stuff that the therapy with my chiro is helping me with. I'm not one who will have to be on opioid maintenance or anything, but I still am worried about talking to anyone about it. I'm afraid either the doctor is going to label me on the spot and refuse further treatment (it's happened before, though not with a specialist) or there will be someone waiting with handcuffs when I walk out of the Doctor's office. What's the right approach? How do you seek relief for pain in today's world without being a "seeker?" I honestly would be willing to take something else that I knew would work. I just don't know of anything at the moment. This is the first time I've ever had to worry about this. At the Air Force hospital, even the pharmacy records were all in the same data base, so with a couple strokes they could pull up my drug history. Well, asks for one every 2-3 months, occasionally needs 1 re-fill, but usually doesn't. Then, bam, there's the script.

    I know that doctors have to be careful nowdays, but I've encountered some who were just plain rude, some condescending, judgmental.... the ones who really listened and took me seriously is the CNP at the WalMart Check-Ups clinic (the only person who would give me my Tram prescription when we first rolled into town) and the Chiropractor. And neither of them can write for controlled meds. The CNP has said that she "can't" do stronger than Tramadol, so I assume that means by law. Well, I'll shut up now. Maybe I can go to sleep.
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    Old 01-10-2008, 03:10 AM   #2
    davids34
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    Re: Help! In alot of pain, don't know where to go anymore

    Just curious, are you in Tyler TX? I had a great family doc there who helped me through a hard time. I would think if you have a buldge then they should focus on a treatment plan that fixes the buldge, not treat the pain.

    Last edited by HBMod07; 01-21-2008 at 10:05 PM. Reason: It is not necessary to quote a message you are directly responding to.

     
    Old 01-10-2008, 04:02 AM   #3
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    Re: Help! In alot of pain, don't know where to go anymore

    No, I'm not in Tyler TX. But we did used to stop there to eat every time we road tripped to and from San Antonio.

    You reasoning, about treating the bulge, well, that's finally why I went to a neurosurgeon. But this flare up comes at a time when I am completely clueless as to what my options are. I never even visited a specialist after onset, mostly because I thought, I'm scared of surgery, so why would I want to visit a neurosurgeon?? LOL. It's really no laughing matter now that I've let it persist so long because the chiropractor thinks that the weakened muscles from the nerve impingement, plus the "guarding" against pain incorrectly has been what has caused the problems with my mid back/shoulder/neck pain/headaches. I think she's probably right, and the MRI showed nothing in the upper areas. Anyway, I just moved here 6 months ago, just got a good thing established with a chiropractor, and finally got into the specialist, who examined me for about 4 minutes then ordered the MRI. He said he "wanted to hold off on doing anything" until after he had the MRI. He has it, but since he's in surgery Monday &Tuesday, I don't have any idea when I will hear from him. And obviously, I was never able to get to sleep tonight because in the positions that didn't hurt the sciatica, the fronts of the hips were aching, like a nerve wrapping around from the back down into the groin area. I could never get both areas comfortable for long enough to fall asleep. So what are my options, at the crack of dawn (or wait until business hours,) in pain, without a PCP, and not really established with the specialist yet? I will refuse to do the Urgent Care thing. I've been treated like trash so many times by those types.

    Still waiting for the specialist to call me back and set up an appointment to talk about what's wrong with me and what to do about it. If he had a magic nerve block needle right now, I'd be happy. My Grandmother just had a nerve block, and it took a couple of weeks to really start working, but now she's feeling much, much better.
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    Old 01-10-2008, 05:48 PM   #4
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    Re: Help! In alot of pain, don't know where to go anymore

    Hello Rose. Dont wait on the doctor to call you, call them! The squeaky wheel gets the grease. I can almost guarantee the neuro will not perscribe anything to you without seeing you again first. Even with the MRIs in his hand. But it's worth a try and you have to ask someone, so why not ask about the meds when you call for the follow up appointment. Seriously, explain that you dont have a GP to bounce over to in this situation and the Neuro wanted the results of the MRI first before doing anything further with you, and now that has left you without ANY pain relief and you are really really flared up right now. Ask them for suggestions. They might even refer you to a GP.

    If you get real bad over the weekend.. the ER is your best bet. They will normally give you a serious painkilling injection and maybe give you a few tabs for home, but that's all.

    Tomorrow's friday.. do some calling around and see if you can find a GP that you can get in to see.

    I try to never let my meds dwindle down to a level where I could be left without. I have done that long ago, and learned my lesson. I make whatever appointments I need in advance to ensure I am taken care of. And I have had to switch docs before and had to ask that doctor to give me refills to carry me for a certain period of time, to find a new doctor and secure an appointment. So far, I've been very fortunate in this area.

    The best approach is the open and honest one. To beat around the bush and act sheepish about it will certainly be a redflag as well as those that take it too casually. And who says we aren't talented with our bad backs, eh? We have to walk a medication tightrope each month! hehehe.

    Hang in there. Keep us posted.
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    Old 01-10-2008, 06:48 PM   #5
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    Re: Help! In alot of pain, don't know where to go anymore

    Okay, I'm losing it here. The nurse called me a little bit ago to tell me that he "can't do anything for me," she was very kind, especially when I was in such shock I began to cry, after a sleepless night and 48 hours of hurting. He supposedly sees no reason on the MRI for my leg pain. Some minimal degeneration of L4-5 and L5-S1 but nothing that he could see to account for my low back/sciatic pain. Also, he didn't know why my foot tingles and aches, as the MRI clearly showed perfectly working nerve signals. Though he did see some areas of muscle weakness, it was nothing he could treat. Honestly, I don't remember everything, and some of it seemed a little contradictory, but I was in such horrible shock, because I just KNEW I was going to be able to prove that something was wrong with me and I wasn't making it up!

    So far, I'm holding up okay. As long as I get my ibuprofen in me every 6-8 hrs, wear the lumbar brace given to me by the chiro, and stick a cooling pain relief patch on each buttcheek, and don't stay in one position too long! I still don't get it. The tech mentioned the disks at those locations, and the chiro says she can feel the inflammation from the outside, in that area. I asked the nurse if the steroid shot would have made thinks look better than they are, and she said "no." The doctor says there is nothing surgical he can do for you. (Why couldn't he try a nerve block? Every doctor in the whole world has diagnosed me immediately with sciatica.) Or are they just like "if you don't need operating on, we don't treat you at all?" I guess the latter is true, because his recommendation was to stick with my Chiro, and if I needed prescription meds, since he's not treating me, he's not writing, understandable, but really like a punch in the gut to me. My hubby told me to get a second opinion. But I'm like "Is getting a second opinion the same as Doctor Shopping? Won't they just all stick together as fellow MD's and continue not believing me? Especially if I pick up my records and there is a big "Drug seeking behavior" label on there. I was especially casual that day at his office visit, because I felt great due to the steroids. And I told him about the shot, but now I'm wondering if he thought I was faking or exaggerating my pain. Which I wasn't. I actually had very little pain that day and told him so, so all of my answers were from memory. Now I just have this awful paranoia that he sent his opinion to the chiro, who I might have had on my side otherwise (she was referring me to a PCP and said she would advocate for me) and now my name is being circulated on the "don't treat" list around the area.

    I know we don't have a state database, my state has remained pretty lenient on it all, but I just don't know how accurate my perception is. Remember, I spent the last few years in the Military Health System, where I got percocet for pelvic pain after child birth. Percs are the go to drug in the hospital. LOL. My friend had the dentist tell her after a complication "Well, I can only give you Lortab this time because I don't like to refill Percocet more than once." And she was PO'd. LOL. So I have no idea, in reality, how much of a sentiment has grown in the last 5 years or so against back pain patients. I do know I've seen signs in Urgent Care Clinics saying Attention: "back pain" patients. Physician does not write for..... in quotes. Like that!

    Anyway, that's where I am right now. A little confused, a little lost, very tired, achy, and I think I'm getting to that point where I'm on the verge of something, I just can't tell if it's a revolution, like a loss of respect for and bitterness towards medical professionals, or acceptance of the psychosomatic-sciatica diagnosis.
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    Old 01-11-2008, 06:49 AM   #6
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    Re: Help! In alot of pain, don't know where to go anymore

    Hello Rose Tyler are you a Doctor Who fan? My name is Dee and I suffer from chronic back pain. When it first started the doc's were very reluctant to give me pain med's, no their answer was 6 weeks of bed rest. Well I can tell you when your sciatica is acting up you can't stay in bed because staying in on position is beyond uncomfortable. I took a long time before someone finally took an Mri of my neck and found a huge problem 3 herniated discs spinal stenosis and bone spurs also no spinal fluid in my neck. You mentioned whiplash so I really think you need to have someone take a look at your neck, and heck yes get a second opinion its your right as a patient to do so. And last but not least find a pain management doctor they are much more willing to give you pain meds, and epidural injections after all that is there specialty . Let me know how it goes Dee


    Ps. Don't give up.
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    Old 01-11-2008, 10:23 AM   #7
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    Re: Help! In alot of pain, don't know where to go anymore

    I just returned home from the hospital last night from my Level 4-5- fuson surgery. I wanted to mention to you that in addition to a lumbar MRI, you need to have standing x-ray where you BEND to the front and to the back. You may have a spondylolisthesis (fancy name for when one vertebra slips over the top of the one beneath it). Spondy results in intense sciatic pain and radiculopathy. It can result in pain and numbness down your leg, into your foot and toes, also across you butt and even into your hip joint. The pain may feel it is in one location, but in fact is referred to another part of your lower body.

    Sometimes they will try steroidal injections to see if they can calm the nerve down and decompress the area around the nerve. I tried accupuncture with some success...but ultimately it turned out I had to have surgery to open up the area so there was enough room for compressed nerves. It is too early to tell you have successful the results are...but I am hopefuly.

    I would suggest you look for an orthpoedic surgeon who only works on the spine -- an orthopoedic surgeon who has a fellowship in the spine. I would ask for an MRI of the lumbar and cervical area with a standing, BENDING x-ray in flexion and extension. This x-ray was extremely important to my diagnosis as it shows the vertebrae being out of alignment. This did not show up on any of my MRIs.

    Your condition sounds very normal and I'm sure with enough digging and persistence, you will get to the bottom of the problem, and figure out a solutation. Just remember that the days are gone where you went to see a doc, maybe a second doc and took their advice, and whatever he mentioned as treatment that would solve your problem. Now the patient must advocate for himself. You must read as much as you can about your back, the problems you suspect, the treatment for these problems. There are some excellent websites where you can learn a lot. Be sure to read from a selection as some are more commercial than others.

    So, read and educate yourself as best you can.
    Get a standing x-ray in bending and flexion from a spinal specialist. Get his opinion. If you're not comfortable with that specialist, find another one.
    This may involve travel on your part...but it is imprtant that you get the best, most qualified expert you can find.

    Good luck!!

    xx Marlo's MOM

     
    Old 01-11-2008, 05:52 PM   #8
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    Re: Help! In alot of pain, don't know where to go anymore

    Dear Rose,
    Please don't give up! I am sure that you have read the other members who have had problems in the medical community and who have had to search for a more respectful doctor. I pray that you will soon find an understanding doctor, who will give you adequate pain relief.

     
    Old 01-21-2008, 09:16 PM   #9
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    Re: Help! In alot of pain, don't know where to go anymore

    Deanneck, I certainly am a Doctor Who fan!! LOL. Glad someone picked up on it. In my neck of the woods, an obsession with anything other than highschool or college football is considered reason for institutionalization! I have a T-shirt that simply says "Whovian" and you can't imagine the number of strange looks and questions I've had about it. I also have a bumper sticker that says "My other Tardis is a Police Box" and that one certainly confounds people. I got pulled over by a State Trooper a couple days ago for speeding who made a point to ask me what my bumper sticker meant. He thought it might be derogatory to police officers. LOL. I also have a hoodie that says "The Doctor's Companion" and that one gets suspicious or even contemptuous looks.

    Well, good news everyone! (Anyone watch Futurama? LOL.) I drove two hours to the town I grew up to see my old PCP. He was completely sympathetic to my predicament and told me that until I could get my records and get relationship established with a PCP in this area, any time I had a flare up, I could call his office and he would make a note in my chart that it would be perfectly acceptable to call in a prescription for pain meds to my local mom and pop pharmacy who I know won't have any issues. Also, my chiro/PT stuff really seems to be working (I'm even tapering off tramadol because I am no longer having daily pain), and my PCP agreed that the conclusions that I have come to with my own research are totally plausible and referred me to an orthopedic clinic for further evaluation. Those theories are 1) my symptoms first started during my first pregnancy and continued, only to get worse with my second. I recalled doctors mentioning that I had one of the worse cases of the condition where your abs tear apart in the middle that they had ever seen. Instead of a little round behind the belly button hole that they usually see, mine have a 4-5 inch separation. So my core strength was shot then. Previously I had a rockin' little tummy, complete with a little 6 pack. I was an operatic soprano, active in musical theatre and dance through college, and ran track through high school. I was also 5'8 and 125 lbs. before pregnancy (all legs and short torso) and carried my babies WAAAAY low and out front. 2) because of hereditary issues and my "loose jointed" long limbed build as referred to by doctors, growing up my gait was obviously bad. My feet turned out and I was slightly knocked kneed. Interestingly enough, my left foot (the side that has most of the problems) turned out way more than the right. As I became self conscious and aware, I began to force my feet and knees straight. It became a total subconcious habit that I still can't get rid of. Now my chiro and the PCP have agreed that I have a major overpronation issue with my feet that could be causing alignment problems, the degeneration, and other muscular skeletal problems leading to chronic pain. The reason it never caused me issues before is because I had such core strength (I was so proud of my tummy. One of my party tricks was to make guys punch me in the stomach to show off) to totally support my back. Then when pregnancy shredded my abs, everything started gradually falling apart. Therefore, if the back doctor can't do anything, the doc believes I could possibly benefit from a podiatrist.

    Thank you all for your responses. I haven't given up, and your support has mean alot. I will keep you updated.
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    Old 01-22-2008, 10:13 AM   #10
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    Re: Help! In alot of pain, don't know where to go anymore

    I am really glad that you are finding help with your problem. That is awesome. Also you will have to tell me where you get your Dr. Who stuff. I am a pretty big fan especially of the year with Christoper Eccleston. I also love torchwood. I ordered an extra cable package just so I could get bbc america to watch those two shows. (lol)
    Any way good luck and keep posting. dee
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    Old 01-22-2008, 04:41 PM   #11
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    Re: Help! In alot of pain, don't know where to go anymore

    (Removed)



    I just wanted to say I am feeling great today. I my last evaluation with my chiropractor was good. She thinks that I am ready to be on my own, but unlike the traditional physical therapists I have seen before, she doesn't want to cut me off, especially since I just got over a flare up. She is pushing me back to once every couple of weeks, then wants to have a maintenance/evaluation type visit every month or two to make sure things are still on track. I am really starting to get frustrated with all this muscle weakness in my left buttock/pelvic/groin. I hadn't realized how bad it was until I started doing an exercise that should have been a piece of cake for a 27 year old. Like I said, I was a runner and a singer. (I'm still a singer, but don't have a venue currently!!) I had amazing strength, tone, and build in my lower body and core. (Never had much upper body strength, but I wasn't a body builder.) Believe it or not the operatic and musical theatre stuff was better for my abs than any exercises. This may sound silly, but it takes incredible core support from the front, sides, and back to sustain notes properly, so I have added scales and stuff to my daily PT stuff just to see. It's obvious that my technique isn't what it once was either, I'm sure due to lack of practice and the sad state of my abs.

    Curiosity question: I, through fault of heredity, have zero elasticity. I think that's why my abs ripped apart, and I am covered in stretch marks from hip to rib cage from pregnancies. Now that I'm back to my pre-baby weight at 125, I have an atrocious looking tummy. The doctor says it is all skin and it's not ever going away. My hubby has promised me a tummy tuck (and a breast lift... nursing was not kind to me) as soon as I am sure that I am through with babies and we have the money saved. I know during the tummy tuck procedure they will adjust your muscles too. Will that include any kind of repair? Anything that will help with my core support? I can flex my abs after 2 years of crunches and they are just as hard in the upper area as they were before. But relaxed they are SO floppy because of the separation. Does anyone have any idea?

    Anyway, thanks for all your support.
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    Last edited by M08; 01-22-2008 at 09:55 PM. Reason: Please stick to board health topic.

     
    Old 01-23-2008, 08:01 AM   #12
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    Re: Help! In alot of pain, don't know where to go anymore

    Hi Rose. I will look for you over at the relationship boards and I will talk to you about being a big time fan girl. Hope all is going well today. Dee
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    Last edited by deeannek; 01-23-2008 at 08:01 AM.

     
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