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



Pain Management Message Board

  • Fentanyl patch questions

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 04-10-2008, 12:45 PM   #16
    scrappinmaniac
    Senior Member
    (female)
     
    scrappinmaniac's Avatar
     
    Join Date: Dec 2007
    Location: USA
    Posts: 281
    scrappinmaniac HB User
    Re: Fentanyl patch questions

    Brian,

    It has only been in the last 30 days that I have noticed my pain being worse on day 3, as well as the gel in my patch being almost completely gone. I have my monthly appt with my doctor next Wednesday, on the 16th, that's when I plan to discuss these issues with her. I have a great doctor and feel fairly certain that she'll change my meds accordingly.

    Thank you for recommending the Opsite Flexifix by Smith & Nephew...I looked it up and it definately appears to be comparable to Tegaderm...minus a gazillion dollar signs ...I'm going to order a roll and give it a try!

    I appreciate your help...THANKS!

    Take care,
    Scrappin'

     
    Sponsors Lightbulb
       
    Old 04-10-2008, 12:55 PM   #17
    scrappinmaniac
    Senior Member
    (female)
     
    scrappinmaniac's Avatar
     
    Join Date: Dec 2007
    Location: USA
    Posts: 281
    scrappinmaniac HB User
    Re: Fentanyl patch questions

    Quote:
    Originally Posted by Executor View Post
    As I've mentioned in a different thread, I'm on a new schedule now where I apply a new patch every day. My new system is:

    Patch 1 on day 1
    Patch 2 on day 2
    Replace patch 1 on day 3
    Replace patch 2 on day 4
    and so on......

    Has been a huge improvement as my BPL is staying much higher.

    Ex
    Ex,

    If you don't mind me asking, what is the strength of the patches you're using?

    Thanks,
    Scrappin'

     
    Old 04-10-2008, 01:19 PM   #18
    Executor
    Inactive
    (male)
     
    Join Date: Jan 2008
    Posts: 3,998
    Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
    Re: Fentanyl patch questions

    Quote:
    Originally Posted by scrappinmaniac View Post
    Ex,

    If you don't mind me asking, what is the strength of the patches you're using?

    Thanks,
    Scrappin'
    Not at all....Was using 37.5 total...A 25 and a 12.5. Now, I'm using 50Mcg total...2 x 25. So, instead of a 50 every 48hrs, I'm using a 25 once a day. Works great! My Doc doesn't believe that these LA meds last as long as they advertise. Add in some individual variety, metabolism, and activity level(s), it's not surprising that patches don't last. Once a day also addresses the "won't stay applied issue."

    Also, I was using generics (Sandoz) and I'm starting brand tomorrow...It's refill day and I had the pharmacy order me the brand. I will report back after a couple of days.

    Ex

     
    Old 04-10-2008, 02:30 PM   #19
    scrappinmaniac
    Senior Member
    (female)
     
    scrappinmaniac's Avatar
     
    Join Date: Dec 2007
    Location: USA
    Posts: 281
    scrappinmaniac HB User
    Re: Fentanyl patch questions

    Quote:
    Originally Posted by Executor View Post
    Not at all....Was using 37.5 total...A 25 and a 12.5. Now, I'm using 50Mcg total...2 x 25. So, instead of a 50 every 48hrs, I'm using a 25 once a day. Works great! My Doc doesn't believe that these LA meds last as long as they advertise. Add in some individual variety, metabolism, and activity level(s), it's not surprising that patches don't last. Once a day also addresses the "won't stay applied issue."

    Also, I was using generics (Sandoz) and I'm starting brand tomorrow...It's refill day and I had the pharmacy order me the brand. I will report back after a couple of days.

    Ex
    Is your doctor's specialty pain mgmt? Do you still find yourself needing b/t meds? Also, have you found the side effects associated with the patch to be worse now, than they were when you were changing the patch every 48 or 72 hours?

    Your doctor may be onto something here...I'm very interested to know how this works out for you, especially once you try the brand name.

    Thanks,
    Scrappin'

     
    Old 04-10-2008, 06:23 PM   #20
    Executor
    Inactive
    (male)
     
    Join Date: Jan 2008
    Posts: 3,998
    Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
    Re: Fentanyl patch questions

    Hey Scrap....Yes, my PM Doc is a pain specialist. He's an anesthesiologist, and primary partner in a very large 5 Doc (and 3 PAs) PM practice. He treats many war veterans & many other complicated patients.

    On this new system, I find myself needing less BT meds, although he has been gracious enough to not reduce them...yet. But, I will probably request they be reduced soon so I don't have to pay for them. My Actiq sticks are very expensive and I'd rather not purchase them if I don't have to. I have no side effects...The only thing that changed when I went to an every day schedule was feeling better. If anything, I think one would have less side effects because you're never putting all 50Mcg on at once...It's spread out.

    If you think about this system logically, it makes perfect sense. Under a 48 hr schedule, you apply a patch and then it delivers meds for 48 hours (or is supposed to). The problem is that I (and my Doc) don't believe that it lasts 48 hours. If one were laying in a bed under a controlled environment, it would. However, most patients are semi-active...They run errands, clean their house, do laundry, some gardening, take care of kids, or whatever. As a result, your body builds up "heat" and you sweat. Add in one's individual metabolism, and practically every patient has a different dosing schedule via the patch. When I was on a 48 hr schedule, the second half of the second day was bad...Sometimes, the second day was kinda rough.

    At the end of the 48 hours, you remove the patch, and apply a new one. Well, it takes about 8-10 hours for the med to reach your system. Meanwhile, once you removed the old patch, some med was in your system that continues to be delivered. But the manufacturer reports that in just 14 hours after patch removal, you get a 50% reduction in BPL (blood plasma level). So, in just 14 hours, you lose 50% of what it took several patch applications to do (stabilize your BPL).

    In theory, as one patch is applied, and the other is removed, they are to cancel each other out, but in reality, it doesn't happen. There isn't enough med from the old patch to offset this completely....Maybe some, but not all. The drug is metabolized and removed much faster than the new one hits your system. Thus, this contributes to the "ups and downs" of PM. Furthermore, if the patch doesn't last 48 hours....Say it lasts 40 or 42 hours, the problem gets even worse. Add in the huge variation in generic patches that we discussed in the other thread of brand vs generics, and the problem becomes almost uncontrollable....Different patches can vary as much as 20%.

    So, applying one 25Mcg patch every day (vs a 50Mcg every other) keeps your BPL very constant. It also helps reduce the impact of any patches that may work loose, sweat off, or whatever. Because my PM Doc is an advanced specialist, I feel quite sure he is on the cutting edge of some new PM theories, so I really trust him. He has been profiled in several magazines and is supposed to be one of the better ones. I will continue to report back for more feedback if anyone would like the info.

    Hope this helps explain things.

    Ex

    Last edited by Executor; 04-10-2008 at 06:26 PM.

     
    Old 04-10-2008, 07:01 PM   #21
    conductor
    Veteran
    (male)
     
    conductor's Avatar
     
    Join Date: Aug 2005
    Location: USA
    Posts: 462
    conductor HB User
    Re: Fentanyl patch questions

    Dear Ex,

    I have been reading your posts with TREMENDOUS INTEREST--concerning the manner in which you use the patch. I don't think the patches distribute their medication with fine-tuned continuity either. For years, I have used 75 mcg patches--changing them every other day. They, frankly, are not consistent. I guess that's where the Actiq (generic) saves me. But, I hate to think I am using the Actiq to correct the "distribution problem" of the patch. I don't want to detect pain the minute my patch isn't correctly distributing. The doctor who originally placed me on the patches and then on the Actiq (when it came out) was an anesthesiologist and a Pain Management Specialist. He made a great big deal out of the fact that he had received very specific training in BOTH. I don't know how true that was, but he was an excellent physician. When he decided to practice several thousand miles away, I truly cried. He had given me so much of my life back that I have to go back and remember it specifically once in a while!!

    Sorry to have bored you. However, your take on the way a patch actually distributes the medication has caught my eye in a significant manner. Thank you, Ex. I enjoy reading your posts.

    Sincerely,
    Jon (Conductor)

    P.S. I use the patch 75 mcg, changing it every 48 hours (15 patches per month). I use the generic Actiq 800 mcg, up to 3 per day--but I just get 2 boxes (of 30 lozenges) per month. If I used 3 per day, I would need 3 boxes (of 30 lozenges) per month--which would cost me the same. This is a way to hold myself off from using 3 every single day! Finally, I use generic Dilaudid (Roxane) 8 mg, 1 bottle of 100 per month. I'm allowed to use up to 120 per month if needed, but I try not to do so! These three meds have been generally the same in strength and dosage for the last 10 years!

     
    Old 04-10-2008, 09:50 PM   #22
    Executor
    Inactive
    (male)
     
    Join Date: Jan 2008
    Posts: 3,998
    Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
    Re: Fentanyl patch questions

    Jon-

    Thanks for the feedback! I have tried to become educated in the field of PM, as it really hits home for me. I also enjoy helping others, and in some small way, hope that I can help improve someone's condition by providing information for them to make their own decisions. I appreciate such kind words from a poster such as you. You are a great resource too, as I always enjoy your posts.

    I too use the combination of patch and Actiq. I also use Oxyfast for BT when the Actiq isn't enough. It's my last line of defense....Knocks me down pretty good, but also the pain. With Actiq, I can still function and do things.

    Are you using a generic patch, and if so, what brand? I'm starting on the brand tomorrow, so I'll let you know something if interested. I've had ups and downs with my generic patches....I swear I can tell the difference patch to patch. I'm sure my activity level (or lack thereof) is in play as well.

    Thanks goodness that your new physician was/is willing to continue your treatment, especially given the potency of what you're taking. As I'm sure you're probably aware, it seems that poster after poster has a story about a change in Docs and how they get essentially "dumped." Hard to believe actually, but then again, not.

    Thanks again for the feedback!

    Ex

    Last edited by Executor; 04-10-2008 at 09:54 PM.

     
    Old 04-11-2008, 12:37 AM   #23
    conductor
    Veteran
    (male)
     
    conductor's Avatar
     
    Join Date: Aug 2005
    Location: USA
    Posts: 462
    conductor HB User
    Re: Fentanyl patch questions

    Dear Ex,

    It seems that our medications are frighteningly similar! As I've probably stated far too many times for your comfort--I use the following pain medications (and for what): First of all, I have Systemic Lupus and the Lupus Anticoagulant. This is why I am on these medications, and I have been on them for many years--I'll place start year in parentheses. (1996) Duragesic titrated up to 75 mcg within a few months and have remained there ever since! (2006, I think) Went to the first of two generic forms of the patch! The first and most hateful was the Mylan--no pain relief, significant withdrawal symptoms. I would have given anything to pay the Brand Name Co-Pay to obtain the relief. However, my pharmacist--a truly grand man who is earning the jewels in his crown in Heaven--quickly ordered the Sandoz brand. He pointed out that the Sandoz laboratory (for this product) had the same, exact address AS THE JANSSEN BRAND NAME. According to my insurance, it didn't cost me anything different. As well, this Sandoz fentanyl patch looked surprisingly similar to the Janssen Brand Name Duragesic Patch! All of the pain relief, the manner in which I perceived it's function, etc., all seemed the same. Even the printing on the patches themselves looked very similar!! The way it all functioned--but at a much lower price than the Janssen--$10 for 15 patches, according to my plan--was almost Biblical!

    (1998--I think) Actiq began being offered. However, I was quickly "not a valid candidate" according to my insurance company because I was not terminal. It was beyond needed to me, but it cost me nearly $900 per box per month. Dearest Ex...I had to use 2 boxes per month! My parents helped me pay for this. (2005--I think) Actiq went generic through the Barr Company. This way, my cost went down from $1,800 for two boxes of Actiq per month to $10.00 for two boxes of this generic Actiq per month! I have not commented a single time concerning this change. It is truly absurd. It's like adding another pay check. The packaging looks almost identical to the Brand Name Actiq. Even the printing on the lozenge itself looks the same, except that the word "ACTIQ" doesn't appear!

    Now, Ex, I do not come from money. My father is a retired minister and my mother is a retired English teacher. Frankly, I'm just thankful in every way I can muster! The only way I can "get by" is that I applied for and, thankfully, receive Disability!! I have enough Medical Records to choke anyone!!

    (1996) I was titrated up to generic Dilaudid (Roxane) 8 mg. I get a bottle of between 100 and 120 per month. It just depends on my needs during each time period, and I must say that my doctor keeps very, very close records. This medication usage has been consistent ever since I was placed upon it.

    While I do have some other incidental medications, these three are my main medications. I do use Fioricet and Fioricet w/Codeine for muscle tension type headaches. These medications have been used regularly ever since I was in college--around 1990!

    I'm sorry to have gone on and on. Thank you for your interest. Again, please know that I am impressed with the manner in which you write. As well, I appreciate your expressions!

    Thank you, Ex! Thank you for always posting what you really, really mean.

    Sincerely,
    Jon (Conductor)

    P.S. I look forward to getting to know you through this board, my friend. Just to apologize in advance, I have been up for a long, long time--so forgive me of many terribly obnoxious grammatical errors! Usually, I try to read and re-read, which I did. I'm just not sure I caught every last thing!

     
    Old 04-11-2008, 05:24 AM   #24
    Executor
    Inactive
    (male)
     
    Join Date: Jan 2008
    Posts: 3,998
    Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
    Re: Fentanyl patch questions

    Quote:
    Originally Posted by conductor View Post
    My pharmacist pointed out that the Sandoz laboratory (for this product) had the same, exact address AS THE JANSSEN BRAND NAME. According to my insurance, it didn't cost me anything different. As well, this Sandoz fentanyl patch looked surprisingly similar to the Janssen Brand Name Duragesic Patch! All of the pain relief, the manner in which I perceived it's function, etc., all seemed the same. Even the printing on the patches themselves looked very similar!!
    Yes, this is all very true. However, all should be careful to stop there. Just because a product is made in the same factory, on the same assembly line, by the same company, doesn't mean it's the same product. I would bet almost everything I own that when Janssen makes the Sandoz (for Sandoz), they take every advantage of the FDA laws. Why wouldn't they? Less ingredients means less cost. Additionally, they want to differentiate their brand...The one they worked so hard to develop and market. If people experience problems with the generic, they will revert to the brand in many cases....I am. You've seen my examples of my experience with a large fortune 5 manufacturing company...We made "off brand" product for our competitors all the time, and we used inferior components because we were manufacturing to a price point, not a quality standard.

    Quote:
    Actiq began being offered. However, I was quickly "not a valid candidate" according to my insurance company because I was not terminal.
    I had the same problem. I was initially denied by Anthem under the premise that the product was only indicated for cancer pain and that my Doc's off label use was not covered by insurance. However, as you know, it is perfectly legal and customary for Docs to write off-label. Happens every day all day by Docs everywhere. I appealed and appealed and eventually won. My PM Doc argued heavily that the human body cannot differentiate pain, therefore it doesn't matter if one has cancer or not. If the med works, it works.

    Quote:
    The packaging looks almost identical to the Brand Name Actiq. Even the printing on the lozenge itself looks the same, except that the word "ACTIQ" doesn't appear!
    Yes, they are identical. Cephalon (maker of Actiq) is manufacturing the product for Barr, who is a big "generic" company. I had to move from 400s to 600s to account for the drop in generic potency. 400 x .8 = 320. Ouch!

    Quote:
    The only way I can "get by" is that I applied for and, thankfully, receive Disability!! I have enough Medical Records to choke anyone!!
    I receive as well, and have quite a medical history. No one is going to hire you or me on these meds. What's absurd is that I have to send in periodic reports (for my private disability insurance) and absolutely nothing has changed. I realize these organizations have rules and policies, but all they really need is a copy of my Rxs. That in itself says it all.

    Quote:
    I was titrated up to generic Dilaudid (Roxane) 8 mg. I get a bottle of between 100 and 120 per month. It just depends on my needs during each time period, and I must say that my doctor keeps very, very close records. This medication usage has been consistent ever since I was placed upon it.
    I've never tried this drug. Does it work well? I use Oxyfast for BT. My Doc post dates everything and the "days" are counted to a T. In 5+ years of seeing him, I've never asked for a date change and he's never offered.

    Quote:
    While I do have some other incidental medications, these three are my main medications. I do use Fioricet and Fioricet w/Codeine for muscle tension type headaches. These medications have been used regularly ever since I was in college--around 1990!
    I used them way back in school as well....Almost the exact time frame as you, but they didn't work very well for me.

    Quote:
    I look forward to getting to know you through this board, my friend.
    Me too. Thanks much for the post. We'll continue to learn about this complex field together.


    Ex

    Last edited by Executor; 04-11-2008 at 05:26 AM.

     
    Old 04-11-2008, 08:09 AM   #25
    ms_west
    Senior Veteran
    (female)
     
    ms_west's Avatar
     
    Join Date: Dec 2006
    Location: western us
    Posts: 7,265
    ms_west HB User
    Re: Fentanyl patch questions

    Jon and Ex -

    I have to butt in this conversation and say that you both are an inspiration to me to have suffered for so many years with cp, you take large amounts of medication and yet you are there for us newbies each and every day. Thank you from the bottom of my heart.

    Pepper

     
    Old 04-11-2008, 03:42 PM   #26
    brianpain33
    Senior Veteran
    (male)
     
    Join Date: Aug 2007
    Location: COLUMBUS, OHIO
    Posts: 2,153
    brianpain33 HB Userbrianpain33 HB User
    Re: Fentanyl patch questions

    Quote:
    Originally Posted by 123dietdrpepper View Post
    Jon and Ex -
    you both are an inspiration to me to have suffered for so many years with cp, you take large amounts of medication and yet you are there for us newbies each and every day. Thank you from the bottom of my heart.
    I have to second this notion. I know that when I first started posting I thought that I knew quite a bit and you guys really sat me down and got me to realize that I needed to "listen". I know that I have taken a huge amount of knowledge and information from you two. I wouldn't have all of the knowledge that I do and be able to help newcomers if I had not learned from you two. Thank you

    brian

     
    Old 04-11-2008, 04:45 PM   #27
    Executor
    Inactive
    (male)
     
    Join Date: Jan 2008
    Posts: 3,998
    Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
    Re: Fentanyl patch questions

    Thanks Brian.....I appreciate the nice words. To be honest, I think we all learn from each other. The key is to keep learning. I pick up bits and pieces all the time. While I have retracted some physically, I still have my mind and given my education, work experience, and background, I feel like I have something to offer to others. I'm trying to turn the negative of my condition into a positive to help others where I can.

    Thanks again....

    Ex

     
    Old 04-11-2008, 05:15 PM   #28
    conductor
    Veteran
    (male)
     
    conductor's Avatar
     
    Join Date: Aug 2005
    Location: USA
    Posts: 462
    conductor HB User
    Re: Fentanyl patch questions

    Dear Pepper,

    You are welcome for anything and everything. Your screen name always catches my eye and guarantees a view (possibly a reply) from me! Pepper, you have a large number of replies, so please know that the knowledge, sharing, and "thank you's" go both ways! I've learned a great deal from you, too. And, I don't say these things if I don't mean them! Sincerely, Jon (Conductor)

    Dear Brian,

    You have regularly made me realize the need to learn. When I started following your story, I read with awe at your difficult plight! And, Brian, you never needed anyone to "set you straight" concerning the knowledge!! Sincerely, Jon (Conductor)

    To Everyone,

    (I don't usually like to follow this same way of answering, but I will use it for now.)

    This whole fentanyl patch use idea keeps morphing, doesn't it? I see that we started years ago with just the Brand Name by Janssen. Then, it changed to having Janssen, Sandoz, and Mylan. Now, there is an additional generic brand. I don't remember the company's name, right now. Plus, people have all sorts of different ways to keep the patches on the skin! I wouldn't be surprised to see that we might need to start another thread to keep this idea going, if needed.

    Sincerely,
    Jon (Conductor)

    P.S. This is to Ex--because she was reponding to me when she mentioned it. Anyone can answer, of course, but I address it to Ex. What is Oxyfast? Is it another form of Percocet or Oxycodone without the acetaminophen? Thanks! Jon (Conductor)

     
    Old 04-11-2008, 06:02 PM   #29
    Executor
    Inactive
    (male)
     
    Join Date: Jan 2008
    Posts: 3,998
    Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
    Re: Fentanyl patch questions

    Quote:
    Originally Posted by conductor View Post
    This whole fentanyl patch use idea keeps morphing, doesn't it?[/U][/B] I see that we started years ago with just the Brand Name by Janssen. Then, it changed to having Janssen, Sandoz, and Mylan. Now, there is an additional generic brand. I don't remember the company's name, right now.
    Watson

    Quote:
    This is to Ex--because she was reponding to me when she mentioned it. Anyone can answer, of course, but I address it to Ex. What is Oxyfast? Is it another form of Percocet or Oxycodone without the acetaminophen?
    Oxyfast is liquid Oxycodone made by Purdue Pharma (same Manuf as OC). Another equal brand is "Roxicodone" in liquid. Each bottle is 30cc or 30 droppers. The dropper that comes with it is almost identical to baby Tylenol. The dropper has 4 lines on it....Bottom one is 5Mg, next is 10Mg, three fourths full is 15Mg, and the top line or one dropper full is 20Mg. Works within 5-10 minutes, max. What I like about it (besides working quick) is that you can titrate the dose depending on your pain. I guess you can do that with pills, but it's easier with a liquid dropper. I use two bottles per month for BT.

    Ex

     
    Old 04-21-2008, 07:06 PM   #30
    WPTN3
    Newbie
    (male)
     
    WPTN3's Avatar
     
    Join Date: Apr 2008
    Location: Memphis, TN, USA
    Posts: 2
    WPTN3 HB User
    Re: Fentanyl patch questions

    Hello everyone, it is a relief to find people that I can connect and relate to. Everyone in my current world has no idea what I'm going through. I am on 75mcg of fentanyl every 48hrs. I still suffer significantly, and I feel my PM doc doesn't take me seriously. I have frequent episodes of breakthrough pain. I have AIDS and my pain is mostly neuropathic. My hands hurt so badly I just want to cut them off, now my toes are starting to act how my fingers did before they got so badly. I'm only 27 and when I asked my PM doc for Breakthrough meds he told me that he was concerned about me, and that in 5 years we would have run the gammet of opiates and have run out of options, therefore he wants me to be evaluated by another pain doc who is also a psychiatrist. I don't understand if there is a stigma with the AIDS, or if the pain is considered "insignificant" compared to those with sickle cell, lupus, cancer, or other serious illnesses. But it is significant to me. I just want to someone to be considerate and take me seriously. I'm not drug seeking, but maybe that's it, maybe that's where the stigma is associated, I don't know. Can someone out there help me or give me some advice. I read you guys, and it sounds like your pain is being managed. I feel that my friends and family don't always take me seriously either, that they don't understand. I hope this new doc doesn't try to tell me it's all in my head. I just want some relief.

    Sincerely,
    WPTN3

     
    Closed Thread

    Related Topics
    Thread Thread Starter Board Replies Last Post
    fentanyl patch not lasting 72 hrs.. due to menopause noescape Chronic Pain 52 02-14-2012 04:12 PM
    Possible Fentanyl Patch Overdose superstressed Pain Management 27 12-05-2010 08:29 PM
    New here - cancer patient w/questions on Fentanyl patch ray of light Chronic Pain 9 03-08-2010 08:14 PM
    lurker posting for the 1st time -- fentanyl patch and percocet questions (LONG) lilsparkle825 Pain Management 0 01-14-2010 10:28 AM
    Executor-? about fentanyl patch/"opiate tolerant" tattoogirl Pain Management 2 09-21-2009 01:43 PM
    New to Board, New to PM and Long Lasting Pain Meds - Fentanyl New To CP Pain Management 64 06-19-2009 10:44 PM
    Help/Advice neededASAP -Fentanyl detox, pain pat. abused meds will need meds in futre Confused089 Abuse Support 34 07-06-2008 05:33 PM
    I have a few questions about the fentanyl patch...all replies appreciated. scrappinmaniac Pain Management 16 05-22-2008 01:38 PM
    Fentanyl questions jennfaery Pain Management 18 02-14-2008 08:47 AM




    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    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




    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 05:17 AM.





    © 2020 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!