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    Old 04-22-2006, 01:57 PM   #1
    madhatter
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    chronic pain-stop making us suffer!

    Some of us are lucky to have a doctor who understands,many of us are not so fortunant.I'm one of the lucky ones. I'm so sick and tired of reading the many posts on this forum of peaple in so much pain,suffering etc. and can't find the right treatment,its disgusting,degrating how doctors can just turn the other cheek!. Like with perscribing pain med. At first i could understand why doc. were hesitant because of the fear of losing there practice. But if someone has proof!,like M.R.Is,or xrays or a written report from a specialist,stating there is a sunifigant injury etc. that person[s] should be treated for there pain! I have come to believe its all about money! For example you go to a pain clinic,the doc. isn't going to make money writing you a perscription for pain med. But he[she] will make a profit giving you all the different[and expensive] shots that are available,even when the patient complains that they are not helping with the pain,they will try a different shot,instead of perscribing med. Sure there are peaple out there that abuse persription drugs,but what about the millions that don't? I've talked to so many peaple with back injuries alone,and have taking so many shots,and they didn't help,or were in so much pain that made poor decisions on getting operations that made them worse off than they were allready.Before my injury,i grew up respecting doctors,and thought it was there duty to do what ever it takes to help there patients,i thought they had to take an oath.Not to long ago a friend of mine had to have knee replacement,after the surgery,his doc. perscribed him lortab 5\500. Mind you my friend is 6 8 and weighs 275lbs. The next day my friend calls his doc. to tell him his leg[knee] is killing him,his doctors responce "i gave you a perscription of the strongest pain med. available". Now i'm no doctor,but judging by his height and weight alone,let alone the type of operation he had,5mg of hydrocodone,he was way under-medicated.I just can't believe how some doc.are.I remember a while back,my doc. retired,so i got prefered to another doc. The doc. looked to see what i was taking[at the time 40 mg oxycotin]and right off the bat,she said i was over medicated,and dropped me down to 10 mg of oxycotin,mind you,the doc. didn't even look at my M.R.Is that i brought,nor did she even read the report! When i brought my perscription to my pharmacist,he was shocked! He suggested i get another doc. A.S.A.P. wich i have now. When i woke up this morning and came on this forum,i realized how lucky i am! And it shouldn't be like that! We go through enough as it is on a daily basis,and for the ones who are under-treated,my heart goes out to you,don't give up! madhatter

     
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    Old 04-22-2006, 02:22 PM   #2
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    Re: chronic pain-stop making us suffer!

    I can understand your frustration and the frustration of others but I don't necessarily believe it is all about the money. For some doctors perhaps it is about the money and pushing injections that are not effective but that is certainly not the case of all.

    Personally I think its about fear and lack of education.

    Fear because the DEA both at Federal and State levels put on such strict restrictions in prescribing narcotic medications that it doesn't take much in certain states for a doctor to loose their liscense. One too many prescriptions or just a little too much dosage of what the DEA deems acceptable can quickly rid a doctor of their medical license and possibly face prison time. In many doctor's minds no patient is worth the risk of losing their practice so they do what they can without having to prescribe medications that may put them under the scrutiny of the DEA and that in turn is where your injections and therapy etc come in.

    The other part is lack of education. Many doctors still believe that patients with a true chronic pain condition can and will become addicted to narcotics. That is simply not true and has been proven time and time again but doctors still fear having their patients become "addicts". This fear often prevents some doctors from providing adequate relief.

    The state of Ohio formed a committee in early 2000 to review why so many people who suffered from chronic pain and they found the reasoning behind it was exactly as I stated. It wasn't about money, it was about fear, fear of the DEA. This committee went to to make proper suggestions to the State in order for the thousands of Ohioans who suffer from CP could potentially get help. These suggestions included proper Education and a bit more lienancy (sp) with regards to prescribing medication in addition to patient education and encouraging more doctors to specialize in Pain Management. The State of Ohio has chosen to do nothing about it at this point.

    Until the State of Ohio actually decides to move on this law or until HB 1020 is actually passed people in the state of Ohio, and across America, will continue to go untreated and undermedicated. I am sure there are many other states in this exact same situation who may have tried to pass laws or proposed legistation to help those with CP but have also hit the same exact brick wall.

    It isn't always about the money.. it's more about the Politics!

     
    Old 04-22-2006, 05:43 PM   #3
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    Re: chronic pain-stop making us suffer!

    Kissa,

    Also from Ohio.They need to fix their laws.There are so many law suits here in Ohio that the good DRs left the state.

    Madhatter ,

    I agree,I left pain management at 2 facilities,all they wanted to do is inject me with shots.They done absolutly no good.I have had 2 back surgeries, suffer from failed back surgery syndrome,possible MS and peripherial nerve hyperactivity.PNH causes my nerves to race constantly then causes my muscles to have chronic muscle spasms.On a pain scale my level is always at a 8. I take baclofen,zanaflex and quinine .My local Drs won't prescribe pain meds,its go to the pain clinic.They wanted to insert a tens unit and a baclofen pump,I won't go back.I should have the final say,when it comes to inserting something under the skin.
    The new neurologist I'm seeing don't agree with the pain clinics,he's going to start treating the pain.I see him next week.

    Toni

     
    Old 04-22-2006, 06:21 PM   #4
    madhatter
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    Re: chronic pain-stop making us suffer!

    Kissa,this is not to do with my back pain,but to do with the money part of it all. a few years ago,i went to my doctors because i had a sharp pain in my upper left shoulder chest area,well i get called in the examining room,they bring in the E.K.G machine,just as they get ready to do the test,the nurse asks me what type of insurance i have,when i told her i have no insurance,they wheeled the E.K.G machine right out of the room! and told me to go to the E.R ! It may not all be about money,but it sure does play a big role.

     
    Old 04-23-2006, 05:07 AM   #5
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    Re: chronic pain-stop making us suffer!

    In my state pain managment doctors will do invasive procedures but only two will prescribe pain meds and the legislature passed a bill last year about allowing doctors to prescribe meds to chronic pain patients. But a doctor told me the DEA came right behind them and made this bill not worth the paper it was written. Frankly, I think it just takes too much paperwork and I do think the quality of doctors especially when it comes to emotionally bonding with a patient is a thing of the past. And I do think some of it is money. I think I have finally found a pain managment doctor, about 4 hours from here. I guess I will lay in the back of the car, because riding in a car is so painful for me. I am trying not to get my hopes up, of course, this doctor is in another state.
    I have told my pcp unless it comes to the point he can not handle my illnesses, and I am in trouble, not to refer me to a specialist or pain managment doctor. I have walked out of pain managment clinics bawling like a baby because I was so mad, so vulnerable and made to feel like I was on the same level of a crack head or meth addict.
    It seems to me, if doctors really cared, they could form a group to protest the undertreatment of chronic pain patients. I have gotten to the point that I have little respect for most doctors now. Yes, there are a few good doctors out there, but the majority are running patients through their offices like cattle going through an auction. And if you are a chronic pain patient, they automatically label you before they or you have had one word. In fact, I rarely get to really talk that much, to explain what I am going through. I don't know, it's just a shame and disgrace.

     
    Old 04-23-2006, 06:48 AM   #6
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    Re: chronic pain-stop making us suffer!

    ruby,what you stated about the documentation part of things i think IS the biggest issue,really.when I was seeing my primary for just my herniated disc,i would discuss my pain with him but also would bring in my little pain diary along too which he would send the nurse to copy the most recent stuff .this WAS my documentaion.and after the spinal cord surgery sent me thru hell and back and caused different types of pain all over my body from five totally seperate pain generators,thats when I had to get really creative.

    i found an illistration of just a person on the internet(I actually used the 'dermatome" man)and from there before evry single visit i had with him,once he started Rxing oxycontin for me,i would take one of the copys of this dude,and actually go and fill in all the areas of my pain and note what they were at on a scale of from one to ten and also write little notes around specific areas that had changed or suddenly instantly would become painful(this was all of the secondary spinal cord injury crap popping over time)but this was the best way for me to actually document the types of pain and the severity of,and it also helped me when we went over it together to tell him a bit more info and all of the stuff I wanted to speak with him about but knew I would forget unless I had it written down on these sheets.

    this saved my doc TONS of his valuable time,and he knew exactly what was going on that particular visit.I know doing this was really appreciated by my doc.I did this with my NS too at every visit and he was actually pretty impressed with the idea.it sure did make that limited amount of appt time much more syratight and to the point.and the DEA was satisfied with all the documentation that would be in my fileif my docs Rxing habits were evr placed in some sort of jeopardy,you know?My primary has been just wonderful for me from the beginning of my nightmare which actually began with that herniated disc,and just snowballed down from there.but he was always there for me.

    Unfortunetly because I was requireing much more oxy and other treatment options,and this was a family prctice type of setting, we talked one day and decided the best place for me at that time was a good pain clinic.luckily they have been,when compared to some i have read about,pretty darn good overall.

    i think if you really do feel that your pain needs better treatment,start doing the documentation to prove that need so your doc does not feel like overwhelmed with doing all that themselves.I know my primary really did tell me that by what I was doing,it was making his job of the paperwork part of things,much easier for him and less of a hassle and wished his other patients would be more specific about how there pain is.

    if you take that obstacle out of their way,it could possibly make a big difference in the overall treatment you will recieve.i think all docs right now with the DEA breathing down their necks constantly,really do worry about the possibility of losing their license,i mean this does happen.I am sure that everytime they read about another "evil"doc being aressted for Rxing too many pain meds,it does have an effect on how they do things,i mean If i was a doc,I would be a bit freaked there too ya know?

    educating all the docs thru med school would really be the way to go here but they don't seem to think that despite the fact that there are over 54 million people out here in the US who are suffering from some form of chronic pain,that it isn't worth it??how screwed up is that?

    I am just really happy when I read about how someone on these boards was not being treated appropriately,finally gets to that wonderful doc who is now treating that pain the way it should be.thats one for our side ya know?it is just really a sad state of affairs when it comes to treating anyones chronic pain.Luckily there are some docs out there who DO care and we are very thankful for that.but it is very sad.no one should have to suffer with pain so awful and undertreated that they cannot even get out of their own bed anymore.now THAT should be criminal.okay,I am off my box now,lol.Marcia
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    Old 04-23-2006, 12:49 PM   #7
    madhatter
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    Re: chronic pain-stop making us suffer!

    Thanks for all the feedback! How does the D.E.A go about targeting a certain doctor? Or do they just target pain clinics?Or do they target certain medications that are being written? For example, they foccus on a doc. they see that he[she] is writing script. for hydrocodone 5\500,say 40 script. for that week,and the doc. has seen 130 patients for that week,do they see that as normal? Compared to a doc. writing 40 script. for oxycotin,and has seen 130 patients for that week.[talking about p.c. doctor] And does the D.E.A mostly target pain clinics compared to regulare primary care physicans?

     
    Old 04-23-2006, 01:52 PM   #8
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    Re: chronic pain-stop making us suffer!

    It's a bit difficult to explain because a lot of it really depends on how active a DEA office is within any given state and the additional DEA laws per state.

    In states that require triplicate forms of narcotics often one copy is sent to the DEA. The DEA then keeps track of how much of any one given substance is prescribed per person and as well as total for the entire practice. The DEA then may have a guideline as to what is an "acceptable" amount of any given prescription based on that doctor's practice or specialty. (GP's for example in some states can only prescribe certain prescriptions for say 6 weeks in a 1 year period total while a licensed PM can prescribe it for an entire year).

    If the DEA in that specific state begins to see red flags of an out of the norm or allowed amount of that presciption it then often sets off an investigation.

    In one state in particular all this information is tracked via Pharmacies which are linked into the DEA. Same thing, if it appears a doctor is prescribing more than they are legally allowed, regardless of situation, it flags them and they get investigated.

    What they are tracking are scheduled narcotics, they do not necessarily look at the other medications like muscle relaxors or anti-depressants.

    I am sure there are other means such as patients reporting, insurance companies questioning prescribing practices and the like.

    Before I actually started seeing a PM my Rhuematologist used to prescribe Vicodin for me. At one point he stopped and reffered me to the PM because he said something about "he is allowed to only prescribe X amount of this drug to one person for a certain period in 12 consecutive months before the DEA investigates him and he could lose his liscense". Hence I was sent to a PM who falls under a different law that does not force those limits with a certain set of documentation.

    From the research I've done in the past many months and case reports I have read for my state only, I can say that the majority of the doctors being investigated where I live are not Pain Management Specialists, they are in fact General Practioners. I think you might find this to be the case in many states, again based on what the prescribing laws per state my be.

    I think many states DEA's do keep close monitoring on PM Clinics and specialists but those types of facilities generally do comply with the laws because they know they may be monitored.

     
    Old 04-23-2006, 04:54 PM   #9
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    Re: chronic pain-stop making us suffer!

    After one of my many spinal surgeries I was under the care of my surgeon for an exceptionally long period of time. It was a case of me coming home from the hospital on, let's say, 3 weeks worth of narcotics for post-op pain, but then I'd break another vertabrae within 5 weeks of the original surgery and back I'd go to the hospital for more surgery. This scenario repeated itself at least 8 times - surgery, home, back for more surgery, etc. So I was breaking vertabrae at an alarming rate and really never got off of the surgeon's prescribed pain meds for months at a time. Well...after awhile along comes the Pharmacy Board and writes my doc a letter telling him that he has written ??? number of scripts for me and ???? hundreds of oxycodone or dilaudid or whatever it was. They are not happy with him and so now I GET A LETTER from my surgeon telling me that he can no longer prescribe narcotic meds for me because the Pharmacy Board has come down on him. And then goes on to say in his letter that perhaps I'm using too many pain pills for the type of pain I'm experiencing! That's when I ended up searching for a Pain Management physician - and luckily I found a great rehab hospital that had a pain management department. But, I can tell you that when I got that letter from my surgeon it made me feel like a serious criminal!! Like it was all my fault that he got a "bad doctor" scolding from the mighty state Pharmacy Board. It totally changed the relationship that I had with him....and believe me it was pretty bad to begin with!! I don't know if all states have a Pharmacy Board that docs need to contend with, but in Maryland I think that's the first "policing" agency that get's notified. Anyone else know for sure?? All the best - KathyMac

     
    Old 04-24-2006, 06:03 AM   #10
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    Re: chronic pain-stop making us suffer!

    There is a really informative site on the net called the DEAs office of diversion control that explains alot of how the programs actually work,along with a ton of other info.I was just reading where only 26 states in the US actually even have any sort of monitoring programs going on .i found that a bit suprising in itself as I assumed that every state would be sort of mandated to have one running,ya know?

    But if you want to check out the site,the page I am giving the URL for is where they have the answers about the actual monitoring programs.this is a .gov site so it okey dokey to write it here:www.deadiversion.usdoj.gov/faq/index.html this particular page is"a closer look at state Rx monitoring programs".enjoy,Marcia
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    Old 04-24-2006, 03:50 PM   #11
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    Re: chronic pain-stop making us suffer!

    IT IS ABOUT THE MONEY. my PM doc told me so, at my first appointment for what was then fibromyalgia (I have MS now), he told me that he's not gonig to give me anys hots like these other clinics in town. he said one shot pays him more than treating me with opiates for 2 years!!! he said he's rich enough and he's not going to make his patints suffer for his next vacation.

    i wnt to a neuro who wanted to give me shots recently and i told him about what my PM doc said, he turned his head, wouldn't look me in the eyes and he said, "really, he actually told you that," then smiled this weird smile. he never offered me a shot again.
    I am so darn lucky to have my clinic, though the CNP treats me and makes all script changes now, she listens to me and works with me, she's a Godsend.

    shots are for the birds, they hurt, they dont' last long, docs get richer o n them when all you have to do is give a pill and it takes the pain away. true, there's addiction possibilities, but it's their job to watch for that, i told them flat out, if you notice any change in me or if you think i'm getting addicted vs phsycially dependant, cut me off humanley.............

     
    Old 04-25-2006, 10:26 AM   #12
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    Re: chronic pain-stop making us suffer!

    Thanks expat64! Thats what i was trying to say,its all about the mighty dollar!

     
    Old 04-25-2006, 07:49 PM   #13
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    Re: chronic pain-stop making us suffer!

    Quote:
    Originally Posted by rubyrearview
    In my state pain managment doctors will do invasive procedures but only two will prescribe pain meds and the legislature passed a bill last year about allowing doctors to prescribe meds to chronic pain patients. But a doctor told me the DEA came right behind them and made this bill not worth the paper it was written. Frankly, I think it just takes too much paperwork and I do think the quality of doctors especially when it comes to emotionally bonding with a patient is a thing of the past. And I do think some of it is money. I think I have finally found a pain managment doctor, about 4 hours from here. I guess I will lay in the back of the car, because riding in a car is so painful for me. I am trying not to get my hopes up, of course, this doctor is in another state.
    I have told my pcp unless it comes to the point he can not handle my illnesses, and I am in trouble, not to refer me to a specialist or pain managment doctor. I have walked out of pain managment clinics bawling like a baby because I was so mad, so vulnerable and made to feel like I was on the same level of a crack head or meth addict.
    It seems to me, if doctors really cared, they could form a group to protest the undertreatment of chronic pain patients. I have gotten to the point that I have little respect for most doctors now. Yes, there are a few good doctors out there, but the majority are running patients through their offices like cattle going through an auction. And if you are a chronic pain patient, they automatically label you before they or you have had one word. In fact, I rarely get to really talk that much, to explain what I am going through. I don't know, it's just a shame and disgrace.
    Thank you, Ruby, for validating what I've been feeling for years. I'm almost apologetic to these drs. asking them to give me some relief. What IS that? What ever respect i had for the profession (which frankly, wasn't overwelming to begin with) has since gone the way of all flesh. Now, I just want them to DO THEIR JOB.

     
    Old 04-27-2006, 09:47 AM   #14
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    Red face Re: chronic pain-stop making us suffer!

    yes yes yes all true it is really sad when one can obtain crack pot or cocaine easy as a trip to the corner but ppl who need care for pain get run through the ringer by the dea and dollar hungrey docs.it is time for change laws that protect truly sick ppl and put the dea back on the street where they should be is overdue,i see it as theese dea ppl finding easy marks to say they have done a good job but really turn a blind eye to the real drug problem street drugs,i have to take the stupid shots too they hurt and dont work,doc wants to try to burn my S1, nerve root but i ask is it a chance it will make me worse he replied yes it a 50/50 chance it could make things worse,it makes no sence why risk more injurie when my pain lvls can be kept in check with proper meds,i refused this treatment,still its try this block and that block blah none have ever been effective.I HOPE SOON PPL IN PAIN WILL SOON ALL SPEAK WITH ONE VOICE ENOUGH IS ENOUGH.i know its hard just dealing with daily pain is very hard and most ppl do good to cope and try to act normal as ppl with out cp dont understand and sterotype us in with addics and slackers witch is the worst,i hate that funny feeling i get somtimes when ppl learn im on narcatic treatment for cp,and the stupid remarks,like they let u drive?ur killing ur self with those drugs,well i hurt but i dont use drugs.and soo on its this kind of attitude that condems us to a life of tring to hide our condition maybe soon ppl will be forced to understand and then we will get the support we deserve.

     
    Old 04-27-2006, 12:24 PM   #15
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    Re: chronic pain-stop making us suffer!

    I had one pain mgmt doc in NC that would do trigger point, epidurals, lidoderm patches and 2 hydrocodone a day when there was proof that there was moderate damage and impingement of my right ulnar nerve and mild damage to my left ulnar nerve.

    She didn't even tell me surgery was an option. I suffered for 3 years like this. She refused to up my pain pills or change them to anything else. She treated me like a drug addict.

    I moved to the other side of the country - went into the health clinic for a refill of pain pills - and the doc looked at my file (primary care doc) and he said 'ya know you can have surgery and fix this right?"

    None of my primary care docs in NC or the pain mgmt docs ever suggested surgery.

    I jumped and was actually pain free for 1 1/2 yrs....

    now I have nerve pain all over my body...but I'm being treated better. I refuse to let hubby be transferred back to Fort Bragg.

     
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