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  • New to Board, New to PM and Long Lasting Pain Meds - Fentanyl

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    Old 06-15-2009, 04:14 AM   #31
    shananava
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    Re: New to Fenanyl, Need help with Side Effect

    I take lots of vitamins. My pcp, PM,surgeons,rheumy, & any other dr I see know about them. I have my levels checked every few months. I will for life because of gastric bypass. Many vitamins affect pains and such in the body. I read lots of info on Vitamin D issues especially with fibro. Rheumy had me on scripted ones for a while. Hope things are working out better for you.
    Shannon

     
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    Old 06-15-2009, 10:41 AM   #32
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    Re: Am So frustrated with the Fentanyl Patches Staying On!!!

    Yes, it does have ripples and waves but it is sticking. I rub my skin down with alcohol to make sure it is clean. After it's dry I put the patch on. I have found I haven't had to use the tegaderm covers in a while. I rotate them, I have one on the left side today and will put a new one on the right side tomorrow;0)
    weezi
    p.s. my breast tend to smoosh together as well, but the patch is still sticking.

     
    Old 06-15-2009, 10:45 AM   #33
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    Re: Am So frustrated with the Fentanyl Patches Staying On!!!

    Allan
    I thought you were putting them under your collar bone. I may try putting it above tomorrow. Do you have any problems since it goes over the bone? Or are you putting it across your shoulder more or less?;0)
    weezi

     
    Old 06-15-2009, 01:49 PM   #34
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    Re: Am So frustrated with the Fentanyl Patches Staying On!!!

    My doctory said it was not good to put anything over it because it may put too much pressure and release more meds. But, I found something to use. I use something called CoverAll/BSN. It is white sticky suff that streatches a tiny bit. They used it on my knee when I was having therapy. I cut a strip that is a little bigger then the patch. It works great. Works in the water. Doesn't come off. Had no side effects of the patch releasing extra meds. I ordered it online. You can get at medical supply stores I think.

     
    Old 06-15-2009, 03:50 PM   #35
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    Re: New to Fenanyl, Need help with Side Effect

    I wanted to tell you that I had a very difficult time when I started on the fentanyl patch because I was going from Ultram(weaker than Vicodin) to the fentanyl patch. On the 3rd, 4th day I had vomiting and it was uncontrollable meaning there was nothing I could do to stop it even if I wanted to. However, I would feel fine (meaning the nausea was gone), I did not have nausea before or after I threw-up, it would just come out of no where. Keep in mind that it only happened 1 time on day 3, and 1 time on day 4.

    However, if you are getting to a point of throwing up multiple times and get to the point of dry-heaving, then that is a sign of OVER DOSE, along with severe dizziness, severe lightheadedness (like so severe that you can barely walk and everything is swirling when you try to lay down), this is definitely OVER DOSE and you should rip the patch off, call 911, or get someone to take you to the ER. Make sure you tell, if you can, that you are on the fentanyl patch. If you feel like you are going to pass out, then call 911, and don't wait for a friend to come get you.
    I do know that the fentanyl patch needs to be carefully used in someone that is also taking other anti-depressants. You said that you are taking Wellbutrin and Lexapro. It sounds like the fentanyl patch is causing you to become manic(don't know if you have ever experienced this before), but it's the chattiness, can't sit still, talking all night, can't sleep, etc. You might need to have your anti-depressants adjusted if this does not go away in a week or so.

    You might also want to postpose exercise for the time being while you adjust to the patch. I know that alot of people are susceptible to exercise while using the fentanul patch. Being that you just started on the fentanyl patch, you should really hold off exercising for at least a week or two. Whenever you exercise, your body temperature rises, and it causese more of the fentanyll to be absorbed into your body. This can definitely cause mild overdose and also cause the fentanyl in your patch running out sooner than it is supposed to.

    I can tell you that I had side effects (and even mild OD symptoms) for the first two weeks. The dose of fentanyl in your body does not completely stabilizer until day 18 - 20.

    This might turn out to not be a good medication for you to be on but it will have be up to you and your doctor.

    brian

    Last edited by brianpain33; 06-15-2009 at 03:51 PM.

     
    Old 06-15-2009, 05:21 PM   #36
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    Re: Am So frustrated with the Fentanyl Patches Staying On!!!

    I haven't had any problems anywhere in general around that area and with guys it seems to be the area with the least chest hair. My collar bone doesn't seem to worry the patches at all.
    Allan.

     
    Old 06-15-2009, 06:22 PM   #37
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    Re: New to Fenanyl, Need help with Side Effect

    Quote:
    Originally Posted by brianpain33 View Post
    This might turn out to not be a good medication for you to be on but it will have be up to you and your doctor.
    Brian makes a good point. The medication very clearly indicates that it is for "opioid tolerant patients only."


    Quote:
    You might also want to postpose exercise for the time being while you adjust to the patch. I know that alot of people are susceptible to exercise while using the fentanul patch. Being that you just started on the fentanyl patch, you should really hold off exercising for at least a week or two. Whenever you exercise, your body temperature rises, and it causese more of the fentanyl to be absorbed into your body.
    Another good pt by Brian. When first starting the patch, it can take up to two weeks for the body to stabilize...i.e your BPL. This information can be found in the white technical paper that comes in the box with the patches. It clearly says that changes should not occur until the body is given time to adapt to the medicine.

    I would stay in close contact with your Dr. regarding side effects and the overall effectiveness. This is a very serious med.

    Best of luck to you.

    Regards,

    Ex

     
    Old 06-15-2009, 09:21 PM   #38
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    Re: Am So frustrated with the Fentanyl Patches Staying On!!!

    Nope, the nasal spray doesn't affect anything except helping it stick and not irritate. It has been a godsend. Give it a try. Like I said, my doctor told me to do this and he is a very well respected rehabilitative medicine specialist. My mom's doc, by the way, is a small town family practioner and he told her it wouldn't work even when she showed him the difference on her own skin.

    Last edited by kathy820; 06-15-2009 at 09:22 PM.

     
    Old 06-16-2009, 12:12 AM   #39
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    Re: Am So frustrated with the Fentanyl Patches Staying On!!!



    Broke as Joke

    Thanks for the advice, but neither of these worked for me unfortunately!

    Kathy Found some Nasacort in my med box and will try this with my next patch change. Have heard of others doing this so too. Hope it works too.Thanks!

    Shananava First, where did you get your 'Tegaderms' online and how much were they. Since we can't post web addys in the rooms, is there anyway you would give me the name of the site via personal message or email thorugh this system? 2nd. I'm glad you understand. The fentanyl was a great idea b/c of the malabsorbsion problems, glad somebody else understand about the skin rippling and what not. I've figured out also that I can't do the heat too much or be outside b/c it just makes me sweat so much and get kinda flustered

    Weezi Since you have breasts I'm gonna give it a whirl. I can't be the only one that has had these problems. Can you put it on your collar bone or above it in the shoulder area. Not a whole lot of fatty tissue there though. Might absorb too much maybe???

    Allan I'm going to try the collarbone and see what happens. It doesn't seem to move that mutch, not like below it does.


    So I went to the pharmacy and bought a single Tegaderm patch (the only sold the single ones) and paid $2.20 for it. Got home and like a dumbsh*t tried to cut the paper edges off and then apply it!! Duh!! That was like working with wet Saran Wrap. Spent 20 minutes trying to get it unstuck to itself and then gave up and threw it out. Went back to a different pharmacy today and bought a whole box of Nexcare Tegaderms to get me by until my Opsite stuff gets here. This time it had directions it it! Yay!!! So i followed the directions this time applying it and so far it's WORKING GREAT!!!! It's so much thinner than first aid tape and it doesn't bunch, ripple, lift of wave even when I move my arm aound a lot. I just hope that the Opsite works as well as these are quite expensive! So, thanks to all of you for your advice and I'm still going to combine methods to make sure these bad boys stay on!
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    Old 06-16-2009, 12:19 AM   #40
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    Re: Extremely Frustrated with my Fentanyl Patches

    Boxerluver -

    Is it really the heat from your hand that activates the glue???? Was that info in the drug packet that comes in the box or did you hear that from your doctor? I've been using a book (goofy I know) to help hold the patch flat against my arm when I apply it, keeping the bubbles and stuff out of it... Maybe I should just try my hand then!
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    Old 06-16-2009, 12:21 AM   #41
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    Re: Extremely Frustrated with my Fentanyl Patches

    NeckPatient -

    Where online did you get the large Tegaderms and what did they cost you??? Can you PM me the website address or the name please? Thanks so much!
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    Old 06-16-2009, 12:49 AM   #42
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    Talking Re: New to Fenanyl, Need help with Side Effect

    First of all, let me thank everyone on here who responded with their thoughts and ideas! It really helped me through this weird time on the patch.

    I had a scare a few days ago with the patch thinking I was having an overdose. I had been feeling a little under the weather with a sore throat and a little bit of coughing. I woke up Sunday morning and vomitted from out of no-where. I wasn't nauseated before or after. I freaked out, ripped off the patch and called the poison control center immediately. After talking with them and 4 pharmacists, we all came to the conclusion that it was NOT an OD of the Fentanyl. Since not being able to get the patch to stick the day before until late that night (was off of it for 10 hours) I had mistakenly taken a Norco early early Sunday morning b/c of the BT pain. I usually don't ever take it on an empty stomach but since I was getting ready to go to bed, I didn't eat anything. Turns out that when you are fighting an illness (viral or bacteria) that your immune system is down making you much more suseptable to outside influences including drugs. Since I had only taken the Norcos two hours before waking up and vomitting, the poison control center and the pharmacists all thought that was the reason for the vomitting. I had NO other side effects of OD either, except for sleepiness (but when I threw up, I had only slept for 3 hours) and they attributed that to just being tired. They suggested that I have someone 'sit' with me and watch me while I sleep to make sure though. After waking up, I felt great, re-applied my patch and used the Tegaderm and have felt 100% better since!!!

    I did get in contact with my dr. today and gave her all of this infomration and we will be having a sit down later this week or the beginning of next week, provided I don't have any other problems.


    Oh, while they DON'T recommend it, the pharmacist as well as my doctor said that it wasn't that bad to use alchohol to clean your 'spot' provided it doesn't cause any irriation to the skin and you wait at least half an hour to let it dry.


    Brian Thank you as well for your wealth of information regarding the possible OD and the anti-depressant info. Besides being a tired (not drowsy or overly sleepy) I had zero other symptoms of OD. What 'mild' OD symptoms did you have when you were first on the patch if you don't mind me asking? I still have only been on it 10 days.

    As far as the exercising goes, my doctor and I decided that I would only exercise on days that I am to change my patch. I'll remove the old, do my exercise, shower and then put on the new to avoid future problems with that. That works well for me b/c I only go to the gym 3-4 times a week anyhow and I can just coincide those trips with 'patch changing days'. As far as cleaning my house goes... well we haven't gotten that far. It looks though as if I'm going to try and do house cleaning late on day 2 or early day 3 when the patch is wearing off a bit and see how that goes. If the same thing happens with the exercise, then I will just have to do it also on the days I change my patch.

    As for the anti-depressants, yes I am very familiar with manics. My doctor's thought that I had bi-polar disorder for a while and I had a dear friend with bi-polar as well so once you mentioned that in your post it was like a lightbulb went off in my head *DUH*. My doctor and I are also going to discuss this when I go see her. I certainly don't want to change my AD completely, but a reduction in dose might very well be effective in keeping down the mania's.

    Executor I did read the information in the packet (but really need to read it again to absorb it all) and do know that it is for people that are opiod tolerant. Since they don't give an exact 'level' or determination of what is, my doctor thought it would be ok to try since I have been on Norco for a long time and did well on the Oxycodone as well. I wasn't taking a huge dose or anything, but I had been taking it rather consistently for quite some time. Do you know what they mean by opiate tolerant??? Are they talking high dose morphine, dilaudid etc...?


    Lindaru As far as the 'catching my breath' thing. I think some of it might have to do directly with the fenanyl although we've been checking my respiration rate and it's been consistently btwn 23-26 (way normal doctor said), partly due to the heat and humidity and also due to anxiety. I've had myself REALLY worked up over these patches for days (worried about OD, side effect, defective patches, long term use, etc) and my doctor thinks that might be part of the problem. She asked me to keep track of when it was happening and write it down. I did and it turns out that 4 out of the 6 times I've had the mild problem has been when I'm online reading posts on her about horrible side effects, reading about addiction to long term pain meds or 'searching the internet' for info on defective patches. She really thinks I'm just working myself up over it and that's part of the reason its happening.


    Thanks again to all of your for your advice, suggestions and concern. It is very touching to know that there are people out there who suffer from the same things as me, have been through a lot of the same things as me and more and who I can talk freely and openly with. This board has been wonderful and a wealth of information for me since I started this whole saga. Have a wonderful week everyone!
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    Last edited by New To CP; 06-16-2009 at 12:59 AM.

     
    Old 06-16-2009, 01:33 AM   #43
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    Re: Really Freaked Out!! Fentanyl OD or W/D, Not sure! Need Advice!!

    Hi Neckpatient, Izzy's Mom & Cat 100,

    First of all, Thanks so much for taking the time and effort to write to me. I can't tell you how muc that meant to me to see that someone who has similar problems, took their precious time to write to me with some of their advice and suggestions.

    What I didn't realize was relevant at the time I was posting (I was in the midst of a total panic attack of course) was that I had been feeling a little under the weather with a sore throat and a little bit of coughing the day before my 'episode' which was Sat. When I woke up Sunday morning and vomitted from out of no-where I really thought it was 'patch related'. I wasn't nauseated either before or after vomitting. As I mentioned, I freaked out, ripped off the patch, sat at the computer and wrote that post. Well still in total panic mode I ended up calling the poison control center immediately. After talking with them and 4 different pharmacists and a NP with my doctors office, we all came to the conclusion that it was NOT an OD of the Fentanyl.

    Since not being able to get the patch to stick the day before until late that night (was off of it for 10 hours) I had mistakenly taken two Norco (which is my dose) on an empty stomach early Sunday morning b/c of the BT pain (around 6 am). I usually don't ever take it on an empty stomach but since I was getting ready to go back to bed, I didn't eat anything.

    Turns out that when you are fighting an illness (viral or bacteria) that your immune system is down making you much more suseptible to outside influences including drugs. Since I had only taken the Norcos two three before waking up and vomitting, the poison control center and the pharmacists all thought that was the reason for the vomitting. They said it's common for people to have nausea and vomitting when taking Norco on an empty stomach and especially when the immune system was weak. They thought that I probably would have never vomitted or been nauseated had I not worken up at 9 to let my dogs out... haha. They said that getting up and moving around was what made my system regect the Norco and make me vomit. I had NO other side effects of OD either, except for sleepiness (but that was due to the fact I had only slept for 3 hours when I got up and vomited) and they attributed that to just being tired. They suggested that I have someone 'sit' with me and watch me while I sleep to make sure though. Regardless of this, I still refused to re-apply the patch at that time since I was so tired and wanted to 'be sure'. I had my mom come over and sit with me for several hours and then while I napped. (I was so worked up by all of it, that despite having taken the insomnia meds I didn't go to sleep for 4 hours or so after talking with the pharmacy and Poison Control) After waking up, I felt great, re-applied my patch and used the Tegaderm and have felt 100% better since!!!

    I did get in contact with my dr. today and gave her all of this information and we will be having a sit down later this week or the beginning of next week, provided I don't have any other problems before then. For the mean time, she is keeping my Rx at changing every 48 in case I start having a lot of pain on day three or around 60 hours (so that I don't run out) but we're hoping that I can make it on the 72 hour switch. She just doesn't want me up and down, up and down with the blood plasma levels and having to take a ton of BT meds.

    I did ask my dr about the 'opiod tolerant' thing and she said that technically applied to anybody that had taken opiod based drugs for at least 3 weeks prior to switching to Fenanyl, but that most people who do the switch have been on much higher levels than I was on. I was taking 1-3 Norco per day on average for many months prior, as well as Oxycodone on a PRN basis for pain that was really bad sometimes. Based on that fact, she thought it would be ok to take the Fenanyl since I hadn't had any side effect of the other drugs in the past. She did mention to me though that it might make me a little 'loopy' at first while I got used to the meds and my BPL was increasing.
    Oh, while they DON'T recommend it, the pharmacist as well as my doctor said that it wasn't that bad to use alchohol to clean your 'spot' provided it doesn't cause any irriation to the skin and you wait at least half an hour to let it dry.

    When I got my second Rx of Fentanyl (1st was only 1 patch) I read the whole 10 pages of do's and don'ts, but the manufacturers packet wasn't in there since it was only one. When I got the 2nd Rx a few days later, I re-read it finally and found where it said not to drink grapefruit juice or eat anything with grapfruit in it b/c it can increase the rate at which the meds are distributed within the body... Who would've though it. I'm just glad I know now b/c I used to drink it on a daily basis and would have run the risk of having a minor OD everyday. Wow.


    My doctor and I have agreed that for now I will only exercise and do housework on 'patch change' days. I will hopefully be able to do some housework on day 3 when the patch is running out, then take the patch off to exercise, shower and re-apply... It wasn't so much that the combo of the patch and the heat made me sick, it made me 'high' and SUPER SWEATY and I don't like either feeling.


    In fact I've given myself several panic attacks this last week when reading about Fentanyl, OD's, W/D, long term addiction etc... My doctor told me to be AWARE and familiar with the risks associated with Fentanyl but not to obsses over them, otherwise I'll alwasy be convinced I'm having one of the three.

    Thanks again so much Krit for your concern and suggestions. I truly appreciate it and know that this board will be very helpful to me in my transition to being a 'CP' patient. Have a wonderful week!!!
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    Old 06-16-2009, 09:58 AM   #44
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    Re: New to Fenanyl, Need help with Side Effect

    Quote:
    Originally Posted by New To CP View Post
    Executor I did read the information in the packet (but really need to read it again to absorb it all) and do know that it is for people that are opiod tolerant. Since they don't give an exact 'level' or determination of what is, my doctor thought it would be ok to try since I have been on Norco for a long time and did well on the Oxycodone as well. I wasn't taking a huge dose or anything, but I had been taking it rather consistently for quite some time. Do you know what they mean by opiate tolerant??? Are they talking high dose morphine, dilaudid etc...?
    Hello....In the prescribing white paper that comes in the box with the patches, there is a conversion chart that offers a conversion of morphine to Fentanyl. Morphine is the "gold standard" in PM....That's why they use morphine as the converter. If a person isn't on morphine, they need to convert their med to a morphine equivalency.

    There's also a chart that shows the conversion of other meds to fentanyl. Most Docs side on the conservative side of the ranges because Fentanyl is so potent.

    "Opiod tolerant" means that a person has been on opioids for a long time and has built up a considerable tolerance. Because fentanyl is the strongest med on the market, it's normally intended for those who can't get relief through other meds. Additionally, once a person builds tolerance to fent, there is really no where to go, except more fent.

    Hope this answers your questions. Best of luck to you.

    Regards,

    Ex

    Last edited by Executor; 06-17-2009 at 08:06 AM.

     
    Old 06-16-2009, 10:16 AM   #45
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    Re: New to Fenanyl, Need help with Side Effect

    I had fentanyl added after being on hydrocodones for over a year. Dont know if he chose it due to inability to take extended release meds, i a supposing it is. Just know that day must have been prescribe Fentanyl day. Heard him giving it to patients in room beside me and people asking nurse about it when she brought out their scripts. I started low, then doubled and went to 2 day dosing after a few weeks. I have been at same level for well over a year. I just have oxy ir added to the patches and hydros now.

    I had no idea at the time it was the strongest med there was. Sad I was already scared of oxycontin but knew nothing about fentanyl. Just didnt know the truth about either med. I just want to feel better, less pain and be healthy at same time.

    You have gotten great suggestions. Just take it easy until you adjust. Dont let the decrease in pain cause you to over do it and hurt yourself worse. Sometimes I think it is better if I feel some pain or I will over do it and injure myself worse.

    Best wishes, take it easy and just follow those drs orders. Seems like they have a plan.

    S

    Shannon

     
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