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  • Hot off the press! Appt with Neuro Dentist #3

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    Old 07-02-2003, 10:16 PM   #1
    Arleen
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    Talking Hot off the press! Appt with Neuro Dentist #3

    Hi Everyone:
    Sorry to keep you waiting. Before I get into my appt, I just want to say thanks for caring, and in case I forget, TC - have a great time visiting mummy bear. I hope she's feeling better. She will when she sees you and your little swimming fishie son. When do you come back, because I'll miss you here?

    Okay, the good news is I really like this dentist. The bad news is his prices are outrageous. So, what to do??

    Reception is a cosy little alcove with an upholstered love seat and arm chair. It felt like sitting on someone's screened in sun porch. There was a large doiley in a shadow box frame containing a note from a patient thanking him for taking her pain away after she'd suffered for years. Also a showdow box containing a note from Janet Travell, on white house stationery, with other white house memorabilia. Above is a picture of JFK. The place was cosy and not at all pretentious.

    The dentist was very personable and down-to-earth. He was very chatty, but in a good way. Unfortunately, I didn't get a chance to ask him my 2 million questions, which is unfortunate, but time just ran out, even though I was with him for an hour and a half. Unlike neuro #1 and #2, his enthusiasm for what he does shows. It sounds like he has all the equipment (EMG, tens, and I believe the magnet tracking thing). I'd be surprised if he follows the straight course that it seems many LVI grads too (he isn't a LVI grad).

    His business card says DDS, dental surgeon, fellow of the American Academy of Pain Management and C.P.P. (Certified Pain Practitioner)- I don't know what kind of certification this is or who does it. He is Chinese and he said because of it, he integrates some Chinese teachings into his practice. It sounds quite holistic. So, I could go to get my teeth looked at, but my appt may also involve having acupuncture (which he does), or a massage , etc. It may involve taking vitamin supplements, or similar if, once he's observed me for a while, he thinks my body or immune system is lacking something.

    Even though this was a consult ($200), he was very thorough in getting an understanding of my problems. He asked me to list what I considered my major problems (I think he had me rank these). I gave him the list of my history, without dentist's name, but near the end of the appt. gave him the list that had names. I think he was just curious (nosy) to see how others had treated my problems. He didn't single anyone out on my list, but has a distain for some of the pain and hospital clinics that patients are shunted to (join the club, so do I!). It seemed like he really wanted to understand what all I'd been through. He also did a quick manual exam. He pressed around my jaw, ears, several areas inside my mouth near the joints, shoulders. Lots of pain. He watched carefully for my reaction to his pressing, and had me rank which areas hurt more.

    Which reminds me, TC, I picked up the tomograms this morning from TMJ dentist #1 (the one who had the hissy fit when I decided not to have impressions done). I'd anticipated problems, but when I called his office last week, the receptionist said to come and get them. Today, no problems. They may me sign a piece of paper saying I'd picked them up. The report of the dentist at the lab where the x-rays were taken says that my condyles are markedly retruded on both sides. Today's dentist had a look and explained the x-rays to me. He said on one side the condyle is forward, not retruded, and on the other side it's pushed right against the jawbone - so he said the report wasn't quite right, although it's the same lab and doctor he uses. He said he'll probably send me for further x-rays there, as he felt a couple of them weren't as clear as he'd like.

    He said that the process of helping me was a long one - possibly a year, although sometimes he's surprised and things go a lot quicker. He also said that once he gets the jaw and muscles all in place, my teeth are probably going to be completely off, so they would need something done. No one has said this to me. I was rather hoping that once the jaw was back where it should be, that the teeth would therefore assume their old positions and all would be well, except that I might need one or 2 teeth built up (or wear a permanent splint instead). It freaks me out. We briefly talked splint, although no particulars - it could be one splint, or two - I don't know. I asked about him using the equipment each time he does an adjustment - he said he doesn't always feel it's necessary. I'm wondering, since he has all the training with Janet Travell, maybe he can tell by feel what's doing with the muscles??? since his approach seems much more to do with having an awareness of the whole body. He also has a 1-800 number, so that if you're travelling anywhere in Canada/US and have a problem, you can reach him.

    Okay, now here's the really bad part, and I will have to call the office for much further clarification. He requires a $3,800 downpayment up front, then each appt is $600!!!! Appts would likely be 1-1/2 hour, no extra for adjustments. There isn't a separate cost for the splint apart from the lab fee charge (anyone know what kinds of fees labs charge?). I asked what the $3,800 was for. He said this is time spent not in the office thinking about my case, etc. I will ask his receptionist for much more specifics about all these charges, and what extra charges I might expect. I'll also have to call my insurance company tomorrow to see what's what. These charges sound outrageous and yet I don't get the feeling at all that he's some sleazy character dentist out to grab what he can.

    So, it's between him and neuro #1. Neuro #1 probably does everything much like Diane and Cheryl (and Robyn in future, and Navy) can expect. I didn't see any passion or concern from neuro #1. I told neuro #1 that low noise and humming sounds were driving me crazy and was there anything he could suggest, he said you'll have to come for treatment. He kinda smile and made a joke of it, but I felt like he wasn't going to tell me anything unless I was a patient coming for a proper (and paid) appt.

    Hope everyone is well today. Cheryl, are you still up? Navy? Hi Diane, you're probably sleeping, getting ready for another busy day. I'm glad your problems ended up being your sleep position and nothing more serious. Must have given you quite the scare. Navy, sounds like you're well on your way. Your dental appts sounded great, although I haven't had a chance to tell you I'm so glad you've found someone good.

    So, sorry yet again, for another very longwinded story.
    Hugs,
    Arleen

    [This message has been edited by Arleen (edited 07-03-2003).]

    [This message has been edited by Arleen (edited 07-03-2003).]
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    Old 07-02-2003, 11:00 PM   #2
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    Hi Arleen,

    We've all been waiting, and you're watching movies?! I really like the sound of this dentist, and from reading your post, it sounds like you do, too. (in more ways than just a dentist!)

    Cheryl

    Last edited by CherylL24; 11-03-2003 at 09:13 PM.

     
    Old 07-02-2003, 11:19 PM   #3
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    Hi Arleen,

    I'm still up. i should go to bed. I'm gld the appointment went well. I'm sure you'll make the right decision.

    i went to mine. I don't understand the sonogram. They are doing another one next week. All i know is that my test went crazy on both sides, the print-out went wild. My right tmj was worse and i don't have problems there. Could be degeneration of some sort according to TC. My husband says we all have it when we get older. Anyway< i'm not sure how my treatment will go if that's the case.
    Navy

     
    Old 07-02-2003, 11:52 PM   #4
    Arleen
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    Hi Cheryl:
    How's everyone in skunk country doing today? Poor Mike, having to sleep with his mummy Not high on the list of things teenage boys look forward to. Oh well, sounds like he's been doing regular teenage stuff lately which is great. I hope you and hubby are having a decent day. At least you got a cardio workout today, and without paying fitness club rates. I would like nothing better than to chase a sweet doggie around the yard. I love dogs. Huskies are so beautiful and usually have such nice temperaments. It's funny but there have been a number of times during this whole TMJD horror that I wondered if I'd be in better shape if I had a dog. There's something calming about patting a dog and looking into their sweet faces.

    I wish I knew what to do. This guy's rates are outrageous and it's doubtful my insurance will pay much, if anything. Apart from the splint, I got the impression that this dentist assesses me each visit and then decides what treatment I should have that day. He said each person's case is individual, so it's probably impossible to get a predetermination from him to submit to the insurance.

    I liked this dentist on a personal level. He seemed decent and like a regular guy. It sounds like he does a lot of research and tries to keep up on issues. So, I'm arguing with myself that I shouldn't make a decision based on personality. Neuro #1 was pleasant enough, not a lot of personality, but so what. He could still be a terrific dentist. He was LVI trained, so we know what to expect much more than with neuro #3. Neuro #1 could probably do a predetermination and his rates shouldn't end up nearly as high as the one I saw today. Neuro #1 doesn't look at the whole body picture...but then, does that really matter. $3,800 is a lot of money to put up front without any services having been rendered. What happens if I put it out and find myself dissatisfied after just one appt. I'll be out over $4,000. That's a scary thought. If money were no object, I'd try #3. I'll have to give this lots of thought. I may post his name and see if anyone knows him. I've done internet searches but nothing's turned up.

    The teeth thing does concern me. This dentist said everything shifts around. I know teeth aren't static, but how much do they shift around, although I've been dealing with this for 20 mths now, so they could have moved quite a bit. This is a question I may put to neuro #1 to see his response. From all I've read, it just sounded like once the jaw and muscles are stable, you're still dealing with your original bite, but if your teeth have been grinded/adjusted, you may need to correct that. Diane? what do you think? Has Dr. Brookover ever mentioned anything like this?

    I have an appt with neuro #3 next Wed. (don't know yet if I'll be going or cancelling??). He would do a complete exam, charting all the teeth, full x-rays, and models. He asked if I'd have models done before, and if so, could I get them and bring them in. My next appt with neuro #1 is a month after my consult appt. I'd have thought they could fit me in sooner. I mean, how many people are they treating who've been going through h-ll for almost 2 years? Maybe I'm wrong in thinking that way, because the world doesn't revolve around me, but you would hope they'd try. I didn't feel good about that at the time.

    Anyway, must start getting ready for bed. It's been a full day. Oh, I just noticed Navy's posting. It wasn't there when I started. Hi Navy. Can't help you with the sonogram. I don't think I've had one. I had a doppler device (like a wand) which measured sound in my joints, but I don't know if it had a printout. Someone here will be able to tell you about it. I'm glad you've found a good neuro dentist who can help.

    Hugs to all,
    Arleen
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    Old 07-03-2003, 12:16 AM   #5
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    Hi Arleen!

    Cheryl

    Last edited by CherylL24; 11-03-2003 at 09:14 PM.

     
    Old 07-03-2003, 06:14 AM   #6
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    Hi everyone!!

    I am running late and shouldn't even be on here, but I had to check on you ladies. This will be my last post until after the weekend. Arleen, I'll be back sometime Sunday. Wow!! This guy must be a fabulous thinker. I can't believe anyone would charge that much just to think about your case. Seriously!! It's true that some of the splint is included, but the prices are VERY steep!! I mean, for $600/appt. you should get adjustments, accupuncture, massage, champagne and caviar to boot!! Goodness!! I'm sorry that you really like this guy and he is so over the top. I know I personally couldn't afford him, as my insurance would think his rates were unreasonable. Good luck with your decision!! Oh, it is my understanding that when your jaw is moved or repositioned, most likely your teeth will not fit together the same way anymore. Then, you must decide if you are going to change your bite in whatever way is necessary, or not. Not a fun prospect, I know!!

    Cheryl, have a great weekend. Don't be chasing that poor puppy around the yard all day...it's too hot for that!! Hope you have some veggies left after the puppy gets through with them. Hope you all have a good time at the BBQ.

    Navy, I hope I didn't worry you. My dentist told me that the level of degeneration in my left joint was more than you would see on a normal 70 year old. I still don't understand it, as one second it can tell you one thing, and the next second it is doubling the numbers, who knows!! Try not to worry about it and have a great weekend.

    Diane, once again, have a great weekend and try to get some well-deserved relaxation!! Keep feeling wonderful!!

    Take care,
    TC

    [This message has been edited by totallyconfused (edited 10-28-2003).]

     
    Old 07-03-2003, 07:54 AM   #7
    Marlene
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    Arleen,

    This is just my 2 cents worth:

    $3800 downpayment UP FRONT?? I'd be somewhat "suspicious" of that. Most, if not all dentists will offer a monthly payment plan (kind of "pay as you go"). You said you were told that money was for "time spent not in the office thinking about your case" - Huh??
    $600 for each appointment?? That's extreme in my opinion.
    Not sure if you'll be able to get a cost predetermination from him? ANY dentist that's dealt with insurance companies generally knows that beyond a certain dollar limit, insurance companies require a predetermination. If he won't give you one, that in itself should tell you something.
    A friendly dentist with a cozy office does not necessarily indicate a "good" dentist. Quite often, it's been my experience that dentists with a bit of an "attitude" are that way because they're "good" (and they know it!). While "chairside manner" is a plus, it's not everything in my book.

    Marlene


    [This message has been edited by Marlene (edited 07-03-2003).]

     
    Old 07-03-2003, 08:24 AM   #8
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    I agree with Marlene that is really steep. My first consult was free.

     
    Old 07-03-2003, 09:40 AM   #9
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    Good morning Arleen -
    I am going to straight the chase here, should be getting busy any time here .. waa, I want to be silly!
    Okay, I read your post, then while taking my shower, I was really thinking about it. Arleen, I am concerned about a couple of things with #3.
    First of all, he should always take readings from each splint adjustment, the adjustment can be such a fine adjustment. I hate to say it but it almost appears that he may have an ego thing going on. :-(

    Okay, the next is worrisome as well. Okay, I understand the $3,800.00 that SHOULD be for all of the testing, which should be about 3 hours and then the making of the splint. It also includes adjustments of 6 months, of which each time he will take anywhere from 1.5 hours to 2, using all of the equipment to ensure a proper adjustment. The cost: $4800.00 (Hey CHeryl, you were right, I sometimes include the cost of the myotronic tens unit).
    Now, I know each office is going to charge differently, but this just seems so odd. As I understand it, $3,800.00 but does not include the "lab Fee" or any adjustments. However there are no charges for adjustments, however each visit is then $600.00? So.. how is the adjustment free?
    Oh Arleen, I do not mean to throw anymore confusion into your life, I would just hate for you to get committed to this guy and find out he is not doing all that you need to get healthy.

    I would call the office, I would ask for real specific charge break down, what is and is not included etc etc.
    I am trying to remember the pro-cons of the nuero#1, as I recall, a cold staff. Not very friendly. But how about the Dr. himself? I can't remember...

    Once you get the actual costs, then I would do a pro-con list of each Dr. Remembering that the office appearance and cost are not as important as to the actual Dr himself.
    Oh Arleen, I hope you are not angry with me, but there just is something that is not ringing true for me with #3 unless we can get some clear understanding about fees and the not doing the readings for each adjustment.
    Hugs Arleen!
    Diane

     
    Old 07-03-2003, 01:05 PM   #10
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    Charges from these neuro dentists can vary a lot, depending on skills, experience, time spent taking measurements and adjustments, etc. I was quoted $3600 for visit/tests/measurements/splint/adjustments by one LVI trained doctor, that I would consider middle of the road in skills and experience. There are additional charges after a limited number of adjustments. Another doc in CA, who teaches at LVI and that I would consider good, quoted me $5500.00, which includes a few adjustements. The best and most skilled of them all, Dr. Chan, director of LVI, quoted me $8000 for everything plus three adjustment visits (all paid in advance in first visit). Any additional visits cost $500.00 each.

    Alex

    [This message has been edited by Al4 (edited 07-03-2003).]

     
    Old 07-03-2003, 04:57 PM   #11
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    I hate to be the negative voice, but the price sounds excessive to me. Sounds like he has packaged his whole practice to go for the big bucks. How much are we willing to pay for the "nice bedside manner" and the ambience? At those prices, he SHOULD be willing to listen to you all day. At how much an hour? Call and check on the prices and add it all up.

     
    Old 07-03-2003, 05:14 PM   #12
    GenDen
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    By the way I went to a TMJ specialist four years ago. He had a picture of himself and Janet Travell that Janet had signed on his wall. For a minute I thought it was the same guy, but then you gave a more specific description and it isn't. He did nothing for me and I paid a fortune for the privilege.

     
    Old 07-03-2003, 05:29 PM   #13
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    Has anyone read "The King of Torts?" I understand neuromuscular dentistry has helped many people on this board, and we may also be seeking help in that area, but when I read that book, there was a scene where all these tort lawyers met at these seminars to learn, not how to be better attorneys, but how to MAKE MORE MONEY! They would discuss the latest fad (sound familiar?) in mass tort, and how to exponentialize (is that a word?) their profits. I get some of the same feeling when I picture the LVI crowd. They know people are in pain and are desperate for help. They throw in these fancy gadgets in the name of science and then use, with some minor adjustments (which may or may not be the key to the "cure"), the same techniques which have been around for years, and THEN figure out how far they can push the patient monetarily before he or she squeals like a pig. Again, I'm not dissing (how do you like that? 41 years old and trying to use 90's lingo) on NM dentists in general--then again, maybe I am. We have gone to one for a (free) consultation, and will go for the initial exam ($200+), because we are in the desperate category. But by the time we get the splint, we will have shelled out $4500. Each appt. after that is about $300. He says appt. 2 weeks after splint, then monthly after that for 3-6 months. Obviously, if this is The One (if I'm in the Matrix right now I wish someone would change the freakin' program), it's well worth it. But no guarantees. And so it goes (who knows that reference?). Take care all, and have a great 4th--oh, I forgot we had Canadians on the board. Oh well, y'all have a great 4th too!

     
    Old 07-03-2003, 05:49 PM   #14
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    Hi Everyone:
    Thank you so much for all your thoughtful and insightful comments. I'm so lucky to have friends like you. Diane, I could never be angry with you, or anyone on the board. I want your honest opinions and I appreciate that you feel comfortable enough to give them to me. I was telling my money tree about neuro #3's charges. Well, the currency slowly started curling at the edges, until each piece was a tight, round ball. My tree's in shock! The tree paramedics were here today administering oxygen and drugs, and the tree's finally stabilized. It's been a rough day on the foliage front

    I liked neuro #3s personality, his holistic approach, the feel of the office, etc. but like Marlene and Diane mentioned, personality isn't the major consideration. And Cheryl, thanks for the math, $11,000 Diane, you mentioned ego. I think there was ego but in a more subtle way. Prior to my appt. he'd asked for a list of the dentists' I'd seen. I told him when I first spoke to him that I was reluctant to provide that and why. At the start of my appt he asked again and I told him again how I felt. An hour later he asked again. I gave it to him at this point, he looked it over briefly and made a few insignificant comments. If I said I wasn't comfortable providing it-twice-I think that should have been enough. I guess, too, his fees reflect ego. I'm not putting him down for this. He's probably very good and deserves to charge those prices. Unfortunately, even my money tree can't meet his prices.

    TC, you really cracked me up - he didn't mention champagne and caviar being included in the price. I hope at the moment, you're having a terrific visit with your mother. Diane, Marlene, Alex, thanks for your comments on cost. Diane, it was helpful to know what you're paying, and Cheryl as well, and Alex, very interesting about Dr. Chan. I also won't be going to him. Can you imagine, $8,000 up front! I have an appt booked with neuro #3 for next week that I'll have to cancel. I don't know what I'll say, as I want to leave this option open, just in case.

    I called neuro #1's office to clarify costs. My initial visit/consult was $30 (very fair). My next visit (full exam, 16 x-rays, impressions, bite registration) is $277. The splint is $4,000, which covers the long 2 hour+ tracking/scanning appt and all adjustment appts. The person I've been speaking to isn't the office manager, she's the "treatment coordinator." She said they'd try to fit me in sooner than July 21, but can't guarantee. I asked how quickly I'd get in for the long appt, since the dentist has to work with the lab person's schedule, because both will be there. Apparently the machine (I'm not sure which one) doesn't live in the office, but comes over from the lab. She said the dentist will be able to discuss the lab person's availability with me at my next appt, but that all these technical appts are done Fridays. I asked if the dentist uses the machines each adjustment and was told she thinks so but to write that question down for my next appt. I somehow feel comforted that LVI trained grads seem to follow a set course with treatment. I was also concerned when neuro #3 said that it would be a long process, likely minimum a year. Most of you are told to wear the splint 3-6 months, and then bite adjustments if necessary.

    So, my dental interviews are over. Yippee! Now on to treatment and hopefully feeling better. I want to eat tortilla chips too, and drink from a straw. Neuro #1's office is sending a predetermination to my insurance company, who'll notify me by mail of what they'll cover. She also suggested seeing if I have extended health benefits (I don't think so) as they're currently working with a patient trying to get them coverage this way.

    And now, how's everyone else doing? Diane, I hate to think I held you back from being silly today. Everyone must have silliness in their life everyday - at least that's my motto. And Cheryl, I laughed just trying to picture you holding a cage, saying "here skunky, here skunky, come to momma." I'm sure you've got nothing better to do with your time. Watching Mike's sleeping habits by night and trapping skunks by day. What a life
    Hugs to all,
    Arleen
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    Old 07-03-2003, 05:56 PM   #15
    Arleen
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    Hi GenDen and Amateurdoc:
    Your posts weren't there when I wrote my last message. Thanks for the comments. Like every profession, I think there are always those willing to take advantage of people who will pay huge amounts, and we're more vulnerable because we're in pain. But I don't think the NM are alone on that. I've seen 15+ dentists in the last year and a half. Three dentists didn't charge me for some appts (I guess they felt bad for me) and then there were several that was overcharged, and of course, there were the middle of the road ones who charged around what the current dental fee schedule recommends.

    Amateurdoc - there is one NM in Ontario that now gives seminars to others on how to bring in $250+ a year!! So, you're not wrong, but each dentist lives with his or her conscience and does what is right for them. I guess our job is to pick out the good ones from the bad.

    Hope you're both doing well. GenDen, funny about the Janet Travell thing, huh?
    Arleen
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