Calling all those with shoulder problems

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nic-nac
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Date Joined Mar 2003
Total Posts : 708
   Posted 3/23/2006 10:19 PM (GMT -7)   
Dear Erin and everyone, I am having terrible pain in my right shoulderand down the top of my arm (on inside) to elbow. Then it goes across my shoulder and about half way down my back on the right side. I have swelling in these areas also. My primary gave me a cortisone shot and another shot that was a half dose of demeral. These did not stop the pain at all. She then sent me to my orthopedic doctor who took x-rays and sent me for an MRI. I won't have any results until April 3rd. In the meantime I am in alot of pain. The Meds I take are vicodan, skelaxin, neurontin,, prednisone. He gave me tramadol to take when I don't take vicodan. I would love to hear from anyone who has had anything like this. He did mention a rotator cuff type of pain, and also something like not enough blood flowing to that area. Does this sound familiar to anyone. I'm about ready to go to the ER but am holding off as long as I can. I'll be waiting to hear from you. Luv and Hugs, Nic-nac


Ducky
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Date Joined Mar 2005
Total Posts : 3199
   Posted 3/24/2006 7:01 AM (GMT -7)   
Hey nic-nac, how are you doing? Did you go to the ER? Please keep us updated when you can.... Duck
Diagnosed January 2005 - Psoriatic Arthritis/Spondylitis
-Currently taking 50mg shot weekly of Enbrel
Diagnosed May 1998 - Graves Disease
-Complete Thyroidectomy September 1998 - While 11 weeks pregnant
Other Complications - GERD/Scoliosis/Hiatal Hernia/Graves Disease of the Eyes
Current Meds -  Enbrel/Prevacid/Synthroid
Past Meds - Inderal/PTU/Prednisone/Voltaren/Feldene/Mobic/Cortisone and Steroid Shots


nic-nac
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Date Joined Mar 2003
Total Posts : 708
   Posted 3/24/2006 2:34 PM (GMT -7)   
Dear Ducky and all, No I didn't go to the ER but today I put in a call to the orthopedic doctor and told his nurse That I was really in alot of pain, and had a lot of swelling. I said that I would like a stonger pain pill or a sooner appointment so that I could see what the  MRI says. She said she would give him the message but he was in another office today and so far I have not heard anything. Ducky, have you ever had shoulder problems?I have RA and like most of you have had pain in almost all the different joints but this is a first for the shoulder. Thank you for your reply and I will keep you updated. Luv and Hugs, nic-nac


Ducky
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Date Joined Mar 2005
Total Posts : 3199
   Posted 3/24/2006 3:19 PM (GMT -7)   
Hey nic-nac, I have had shoulder problems in the past, but I have PA and once I started on the Enbrel, the pain went away. Not totally, but now it isn't a constant pain, only an occasional pain. Did your doc ever get back with you? I hope so with it being Friday and all... if it gets worse, are you going to go to the ER? Thanks for keeping us updated... Duck
Diagnosed January 2005 - Psoriatic Arthritis/Spondylitis
-Currently taking 50mg shot weekly of Enbrel
Diagnosed May 1998 - Graves Disease
-Complete Thyroidectomy September 1998 - While 11 weeks pregnant
Other Complications - GERD/Scoliosis/Hiatal Hernia/Graves Disease of the Eyes
Current Meds -  Enbrel/Prevacid/Synthroid
Past Meds - Inderal/PTU/Prednisone/Voltaren/Feldene/Mobic/Cortisone and Steroid Shots


erin.K
Veteran Member


Date Joined Mar 2005
Total Posts : 3148
   Posted 3/24/2006 8:35 PM (GMT -7)   

awe nic nac,

this is some problem huh?  to me...this is a radiating pain, it spreads from one area. in my opinion it sounds similar to a nerve compressed. the swelling though throws me off a bit...but you have RA on top...so the edema could be worse.

lack of blood flow to the area can indeed cause difuse pain in those areas. do you know if you have any blocked arteries?

seriously, if you feel up to it...i would go to an emergency clinic (a walk in place) if you want to avoid the ER...just to have an EKG done you know?  with arm pain and shoulder pain like this...you can't fool around with it being heart related.  are you nauseous? how's the left side?

i say bologny to having to wait that long for your MRI! i bet if you're on em long enough you'll have that MRI result tomorrow or monday.

this arm isn't turning blue or extremely pale or cold right?

i sure hope you get to see someone tomorrow.  if demerol isn't cutting it....perhaps dilaudud will.

i would defintely investigate further. arm pain that spreads is tricky.

you rest up and don't do too much running around.

be safe,

erin


Active, Severe RA. Crohns Disease. Chiari Malformation & Right Brain venous anomoly. AS. Emphysema. Rheumatic Lung. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg every 4 days; pred; Pentasa; Imuran; dilaudid; diazepam; Avinza 30mg; MiraLax & too many others.


nic-nac
Veteran Member


Date Joined Mar 2003
Total Posts : 708
   Posted 3/24/2006 9:19 PM (GMT -7)   
Dear Erin, Ducky, and all, I did not go to the ER but the orthopod did call me in a stronger pain med. Thats what the nurse said ,"This is a stronger pain med,". When I went to get it it was Darvicet. I don't think this is a stronger pain med. I was on vicodan to begin with. I am not nausiaus, and the left side is fine with no pain at all. I don't think I have any blocked arteries.The arm is not turning blue and is not cold. I wish they would try me on dilaudud. It is very hard to sleep as I sleep on this side. This is the same orthopod that replaced both of my knees. He also asked me if I'd had a fever and I said no. However, right before I got this arm and shoulder pain I had the flu for about a week with fever. Do you think this is relevent?? It is so nice to have you girls to talk to, this is a wonderful support group. Thanks for the replies. Luv and Hugs, nic-nac


Ducky
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Date Joined Mar 2005
Total Posts : 3199
   Posted 3/25/2006 7:11 AM (GMT -7)   
No, Darvocet is not stronger than Vicodan. Hhhmmmm... Did you tell him about having the flu with the fever? How are you doing today? Maybe if you go to the ER they will give you dilaudid... you might want to think about doing that this weekend if it gets too bad... will be thinking of you... Hang in there and let us know what we can do for you... Duck
Diagnosed January 2005 - Psoriatic Arthritis/Spondylitis
-Currently taking 50mg shot weekly of Enbrel
Diagnosed May 1998 - Graves Disease
-Complete Thyroidectomy September 1998 - While 11 weeks pregnant
Other Complications - GERD/Scoliosis/Hiatal Hernia/Graves Disease of the Eyes
Current Meds -  Enbrel/Prevacid/Synthroid
Past Meds - Inderal/PTU/Prednisone/Voltaren/Feldene/Mobic/Cortisone and Steroid Shots


erin.K
Veteran Member


Date Joined Mar 2005
Total Posts : 3148
   Posted 3/25/2006 11:34 AM (GMT -7)   
eyes  hmmmm? so sorry for the trouble hon.  have you ben on Darvocet before?  given the strength of it...it is a powerful pain killer plus it has an acetaminophen compound in it to help the narcotic part work better. 
how is your pain level today while taking the darvocet?
also, you might find that taking it around the clock...whether it be every 8 hours or every 4 hours; will help the pain more than taking it just when needed.
 
personally, i have dilaudud 4mg tabs. and when my jointpain is bad, even THEY don't really get a grip on the pain! in the ER when they give dilaudud IV, that works much better.  i end up having to take prednisone and or tylenol with it as well.
 
i would also use some heat/ice whatever feels better on the arm.  when my shoulders got real bad in the summer...it sounds so simple but ice was the only thing that stopped the swelling and throbbing.
 
this sounds like you're going to have to go through quite a few medicine combos until you find something that controls this pain.
 
the virus you had could definitely have left you with extreme muscle pain in your arms and back. takes a while to disipate.
in the meantime...try not to move the arm around too much or aggravate the joint. stretch lightly if it feels tight, try to hold on till monday...if you're not content w/ the Darvocet the doc has to listen to you! perhaps then he'll order a dilaudid to test out. (it is short acting though! wears off after 2 or 3 hours).
{{{{{{{{{ big hugs to nic }}}}}}}}}}}}}}  i'm wishing your pain away right now.  :-)    :-)    :-) {{{{ go away, go away, go away!}}}}}}}}} :-) :-) :-)
Active, Severe RA. Crohns Disease. Chiari Malformation & Right Brain venous anomoly. AS. Emphysema. Rheumatic Lung. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg every 4 days; pred; Pentasa; Imuran; dilaudid; diazepam; Avinza 30mg; MiraLax & too many others.


nic-nac
Veteran Member


Date Joined Mar 2003
Total Posts : 708
   Posted 3/25/2006 10:48 PM (GMT -7)   
Dear Ducky, Erin, and all, I did not tell the doc about the fever that I had with the flu because I thought he meant did I have fever right then. I'm still not sure what the question meant but I will be sure and tell him about the fever when I go back. He also mentioned something about prednisone-induced something or other. He was talking very fast and I should have just asked him to slow down. Erin the tramadol is 50mgs. and the darvocet reads darvacet-n-100w/apap650 tabs. Take 1 or 2 tabs every 6 hours. This is what I've been doing today. I guess it takes the edge off but does not take the pain away. I cannot straighten my arm overhead or lift my arm straight out from my body.
       Enough about me how are you girls feeling this week-end? I do appreciate your kindness and caring about my problems. It is so good to have a support system of people who really understand what your going through. I have been using the heating pad and ice most of the day. I think the heat helps the most. Also when I move my arm in or out it makes a cracking sound. Just one time. Thanks for listening. Luv and Hugs, Nic


erin.K
Veteran Member


Date Joined Mar 2005
Total Posts : 3148
   Posted 3/26/2006 2:36 PM (GMT -7)   
Hi Nic,
Hmmmm?...I think I know the 'prednisone induced something or another"...has to to with the ligaments and sockets and stuff; but when I get home & have access to my books I will certainly look it up. 
That's a good doseage of the Darvocet.  Take the 2 pills at each time if that's what it takes to get you a little more comfortable.
Remeber, you can always call him back over the phone & have him reiterate what he said. A simple, "can you explain again about the prednisone issue you were speaking of" & tell em' about the fever too. Maybe you can accomplish a little via telephone. 
 
How's Erin?  She's got a pulse...so I'm not gonna complain. :-)
Active, Severe RA. Crohns Disease. Chiari Malformation & Right Brain venous anomoly. AS. Emphysema. Rheumatic Lung. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg every 4 days; pred; Pentasa; Imuran; dilaudid; diazepam; Avinza 30mg; MiraLax & too many others.


nic-nac
Veteran Member


Date Joined Mar 2003
Total Posts : 708
   Posted 3/26/2006 5:12 PM (GMT -7)   
Dear Erin, thanks for the reply and for thinking of me. I have been taking the 2 darvacets all day, but truthfully I don't see where they are doing anymore then the vicodan did. I will call his office tomorrow but it will be a miracle if I get to talk to the doctor himself. I don't know how it is in your part of the world but here in the midwest it seems like they always have a receptionist running interference for them. You tell them what the problem is and then the receptionist gets back to you. He didn't used to be like that but I guess the busier they get the more they delegate their work. I'm glad you still have a pulse ha ha , but I know for the most part your health problems make mine look pretty minimal. I do appreciate your looking for that prednisone-induced whatever in your books. Hopefully you will be able to find it. Have a good whats left of the week-end and will talk to you soon. Luv and hugs, Nic


erin.K
Veteran Member


Date Joined Mar 2005
Total Posts : 3148
   Posted 3/27/2006 2:20 PM (GMT -7)   
  :-) Hey NicNac,
How are you doing with the shoulder? Any better/worse/same?
In my neck of the woods the docs & offices are the same.  Very rarely do you get the actually M.D. call back (unless it is high complexity) but some MA's (medical assistants) are very skilled and they are just as good at relaying the docs messages. (Hey I was one!) But true...playing telephone?...ya do tend to get lost in the run around with receptionists, lost messages....etc.
 
My GI actually is great. I've had many phone appts with him! tongue hah. And he calls you back within like 15 minutes. He also schedules his own appointments with you on the phone.  In Manhattan, my rheumatologist corresponded with me via email, which was very cool.  My rheummy in NJ...I usually get the receptionist. So I guess it's a crap shoot.
 
Ok, now with the steroid thing. Correct me if I am wrong, but you recieved the cortisone through injection in the shoulder?  This form can cause very bad muscle pain and if it was given too close to the radial nerve in your arm...it could be causing a lot of pain that way too.  If the shot was given intra-articularly (into the shoulder joint) there could be a risk for infection...which would show up in an XRAY or MRI and even blood work (elevated WBCs).
Another thing I can think of, if you are on any medicines that have fluoroquinolone ingredients: (antibiotics like Cipro/Levaquin/Penetrex/Tequin/Floxin/Trovan...) there runs a risk of tendons rupturing when given steroids. This also you would need films taken to see.
skull  It is written in my Drug reference guide : Patients should report promptly unusual swelling and bone pain.
Well Nic, I sure hope you got a hold of someone today or at least your MRI results. If there is anything I can look up for you or you want to know...just let me know. Be more than happy to...I've forgotten a lot of steroid information so you'll be a good refresher course. smurf You take care & let me know how you are doing. (Gee I wish I had a jet. I'de make house calls...nation wide.LOL tongue ) Erin
Active, Severe RA. Crohns Disease. Chiari Malformation & Right Brain venous anomoly. AS. Emphysema. Rheumatic Lung. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg every 4 days; pred; Pentasa; Imuran; dilaudid; diazepam; Avinza 30mg; MiraLax & too many others.


nic-nac
Veteran Member


Date Joined Mar 2003
Total Posts : 708
   Posted 3/27/2006 9:59 PM (GMT -7)   
Dear Erin, You were right the shot was put in the shoulder and not in the joint. I can see how this could cause muscle pain. The next one is given in a different way though. You are certainly a wealth of information. I don't know what we would do without you . I wish you did have a plane and could just make house calls to all of us. I know I feel better after just talking to you. How are you and Ducky feeling tonight? I hate to talk only about myself. BTW I am not taking any antibiotics at this time. Well, thanks again, and have a good night. Luv and Hugs, Nic


erin.K
Veteran Member


Date Joined Mar 2005
Total Posts : 3148
   Posted 3/27/2006 10:17 PM (GMT -7)   
Awe Nic thanx.  :-) You know, being away from nursing & not being to be able to do bedside and unit care/work; this here & what I do studying while taking a grad course online is like my only connection to nursing.  I'm really disapointed...watching all my girlfriends that have graduated and are all off working and I wish I was doing that. In fact, my one friend (she'll be graduating in a few weeks) she was so nervous and all and I would always calm her down when having to do a procedure or if she didn't know how to hang an IV right....AND NOW she's having so much fun and doing great...I guess I just miss everything and everyone. sad
My boyfriend is wonderful & supportive, but again I hate for him to have to watch me like this.
Yesterday was a good day. We went grocery shopping & I cooked a real kickin' dinner. That makes him happy.  I go a little nuts...I like ambience and table settings and candles. We light up our palm tree (in christmas lights!), put some Dylan on...plenty of vino! LOL.
And when I accomplish something like that (which is far & few between) I feel real good about it.
I wish I had consistant days. Disapointed too in that my joints have got worse & not better despite treatment. But am pushing forward within the next month with my rheummy. He needs to start getting as aggressive as my GI, then I think I will be getting more results.
Today I was content and happy I walked for about 5 minutes outside. Twice! So that's 10! tongue Never losing hope.
Thanks for listening. And I am happy you found out what is going on with your arm. You'll be in my prayers that the pain dissipates as the week goes on.
Nighty night. smurf
Active, Severe RA. Crohns Disease. Chiari Malformation & Right Brain venous anomoly. AS. Emphysema. Rheumatic Lung. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg every 4 days; pred; Pentasa; Imuran; dilaudid; diazepam; Avinza 30mg; MiraLax & too many others.


nic-nac
Veteran Member


Date Joined Mar 2003
Total Posts : 708
   Posted 3/28/2006 9:17 PM (GMT -7)   
Dear Erin, Well, I went back on the vicodan today. It seems like that helped the pain more then anything. I know you are disappointed about not being able to work in the career that you love. We just have to pray that your time will come, and you will be hanging those I.V. bags just like your friends. You are so knowledgeable about medical issues , maybe there is a reason you are here in this place right now. You know what they say about when one door closes another one opens. I know this probably does not make you feel any better, but I truely believe your time will come as a nurse. I'm glad you are staying connected with your online grad course.I'm sure your boyfriend loves you and just wants to be there for you. Your dinner sounds wonderful. I'm sure he appreciated all that you put into it. Ten minutes of walking sounds good to me. Just keep going when you can. I don't think my rhuemy is aggresive enough either. I'm going down hill, not even at a stand still. You are always such a positive person with a wonderful outlook on life. You know your always in my prayers too. Luv, Nic


cbrossman
Regular Member


Date Joined Apr 2005
Total Posts : 191
   Posted 3/29/2006 11:48 AM (GMT -7)   
When my RA first started kicking me in the pants, it attacked my shoulders, but usually one at a time. During Memorial Day Weekend in 2004, I was in the emergency room 4 times with terrible shoulder pain, and I was already loaded up on oxicodon and morphine.
This was the official start of my RA, though we would not know it for several months.

It would attack my left shoulder one evening, the right the next night, move back to the left elbow ... Weird, and I suppose, made it pretty difficult for ER types to figure out what was going on.

Since then, Enbrel and MTX have kept me pretty healthy, including several physically stressfull situations like injuries, hard workouts, and lack of sleep.

I guess my conclusion is, that for me, shoulder pain (terrible pain!) is just another side affect of the RA, but certainly not the only one. There is hardly a joint it has missed, but the shoulders have been by far the most painful.

I had the cortizone shots, x-rays, MRIs as well, with no clear indicator of a real problem. I think the problem was simply RA, and now that it is under control, the terrible shoulder pains have not come back to haunt me. Perhaps your RA is not under control? I don't think you mentioned Enbrel as one of your coctails. I was on a bunch of stuff, including MTX for 3 months with very little benefit. Enbrel, after 2 months, did the trick.

Anyone want to ride in Sedona this weekend ... Craig

erin.K
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Date Joined Mar 2005
Total Posts : 3148
   Posted 3/29/2006 3:50 PM (GMT -7)   

thank you Nic for everything.  hey...whatever works best for you, that's the ticket. do you have a rolling order for Vicoden?  i hope it works well (continues to). the WORST thing was growing tolerant to a pain med. ugh!...with the Darvocet i was taking 2 pills every 4 hours! HELLO LIVER!!! so i said to my PCP (he's a sweetheart) "I'de like to hang on to an organ that actually works right!" so that's when he put me on Avinza 30mg, an ER Morphine & dilaudid for BT pain (breakthrough pain).

oh God the shoulder pain! Craig, i don't know what was worse!  not being able to use my legs or not able to use my arms!  the shoulder pains drove me to the ER several times too. since the Imuran, knock wood, the elbow/shoulders haven't flared to the extent they did last summer. but yeah, excrutiating.

be good & have a safe trip to Sedona.

Nic...still have that appointment for monday? good luck. hope you have an OK nite with little pain. rest well.

erin


Active, Severe RA. Crohns Disease. Chiari Malformation & Right Brain venous anomoly. AS. Emphysema. Rheumatic Lung. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg every 4 days; pred; Pentasa; Imuran; dilaudid; diazepam; Avinza 30mg; MiraLax & too many others.


nic-nac
Veteran Member


Date Joined Mar 2003
Total Posts : 708
   Posted 3/29/2006 9:48 PM (GMT -7)   
Dear Erin and Craig, Craig I am on Methatrexate and prednisone and folic acid for the arthritis.I am also on neurontin, and skelaxin and vicodan. You are correct in saying maybe my arthritis is not under control. That is an understatement. I had been on Humira but got many infections that put me in the hospital. For this reason I believe my rhuemy is hesitant in putting me on another one of those type of meds. That is exactly how my RA is though, from one joint to another. This time however, after an MRI, they said I have a torn rotator cuff. So Monday, yes Erin still Monday, they are starting on a series of steroid shots.I'm glad your under control Craig. Erin, It was my primary who put me on the vicodan. It still works better then the tramadol, and darvacet that we just tried. I do have alot of breakthrough pain though. What is Avinza? I haven't heard of that one. A while back she put me on the fentenyl patch and it was just too much medicine with all my others. I ended up in the ER with halucinations. Embaressing to have to admit that. Fentenyl should never be taken with vicodan. Live and learn I guess. Erin, I'm still praying for you. I both of you guys have a pain-free night. Luv and Hugs, nic


erin.K
Veteran Member


Date Joined Mar 2005
Total Posts : 3148
   Posted 3/30/2006 12:39 AM (GMT -7)   
thanx a bunch. PAINFREE NIGHT? pray harder! LOL. it's 0230am and still up. see, i pushed myself today for a walk a bit longer than before, and incredible leg & knee pain tonite. but....this too shall pass. 70 degrees tomorrow and looking forward to it.
Avinza is a fairly new extended slow release morphine. starts @ 30mg each day. the first layer disolves within 3 hours & the rest of the capsule dissolves over 24 hours. been on it 2 months now. i have to be cauitious though...prone to obstructions due to Crohns, and I DON'T WANT ANOTHER ONE! so the Avinza, i do not take it everyday. if can go without it for 2 days i'll shoot for that. morphine is very constipating, and that means big trouble for lil ole me. no happy medium, either everyday diarrhea or 13 days no bowel movement! ugh. but GI has me on nifty bowel cocktails to prevent the obstructions while taking the needed narcotics. i like the Avinza; you forget you had taken it because it doesn't cause a drowsy/drunk/sleepy dopey feeling like regular acting opioids. so it's great in that aspect. so when i FINALLY ONE DAY can work, that'll be a good pain medicine for me...can be alert and still under pain management. but i did hear that other folks get really drowsy on it. everybody's different i guess.
hmmmm? fentenyl and vicoden? the combo has to be monitored. the 2 drugs can build up in the blood stream and can cause respiratory depression. was a high dose of fentenyl?
speaking of pain meds...i just downed some chocolate, justified by the fact i have to take a few more dilaudids tonite. LOL. is that an excuse for chocolate? Cadburry easter strawberry egg chocolate! eh, kinda yuck...no Godiva by any means.
goodnight, hopefully soon!
erin
Active, Severe RA. Crohns Disease. Chiari Malformation & Right Brain venous anomoly. AS. Emphysema. Rheumatic Lung. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg every 4 days; pred; Pentasa; Imuran; dilaudid; diazepam; Avinza 30mg; MiraLax & too many others.


nic-nac
Veteran Member


Date Joined Mar 2003
Total Posts : 708
   Posted 3/30/2006 10:43 PM (GMT -7)   
Dear Erin, OK Erin, I'm praying as hard as I can, and will continue to do so until you see some improvement. I think I will inquire about that Avinza. It sounds as though you have a wonderful G.I. We should all be so lucky with our rhuemy's , orthopods and such. The fentenyl patch was 100 mgs. to be changed every 48 hours. Way to much with the vicodan. My shoulder is giving me a fit tonight. I don't understand if the tear is in the rotator cuff why it hurts all the way down to my inner elbow. Anything in that general area worries me because I had a blood clot there that happened because of a pic line. So much about me. How are you feeling tonight? Are you with your honey?I hope your much better then yesterday and that you'll be able to sleep. Luv and hugs, Nic

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