First time writing, just some questions

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

Japey
Regular Member


Date Joined May 2010
Total Posts : 29
   Posted 5/23/2010 4:22 AM (GMT -7)   
I've followed off and on over the years since I was first diagnosed back in 2004, but have never written on this site.

A bit of background info:
I'm 23 yr old female. Currently a full-time student, part-time hostess. I was diagnosed back in October 2004 (17 yr old). I had become so sick I lost almost 30 lbs over a month. After about half a year of trying to figure out what was wrong, I was put on a few different medications, pentasa and entocort, for sure. These helped a little bit, though it took me a while to get to a point where I wasn't so sick. Over the next 2 years, I didn't gain hardly any weight back. I was still very ill. Once I reached 20, I had gained back all the weight, and my GI doc took me off all medications. I started going into a flare-up again, the pain came back, and I started to lose some weight, but because the numbers (c-reactive and albumin) weren't bad, he didn't want to put me back on anything. It started to interfere with school, so I went to get a second opinion. The second GI was a quack. He told me it was absurd to suggest a person my age could have and IBD, and that I only had an IBS. I followed his regimen of antispasmodics for just about 6 months before I couldn't take it anymore, and I went and got a third opinion. This doctor is much nicer and listens so much better than the other two. And I found him just in time too, because I've been going through a fairly bad flare-up.

When I first met him, he did the usual round of scans and stuff, since I hadn't had some in about 2 years. I have inflammation both in my ileum area, and mildly throughout the lower small intestines. He prescribed me a 800mg asacol 3 times a day, and prescribed tramadol for pain when I really needed it. This worked for a while, until I flared up during the past holiday season. I got a flare-up so bad that it spread to my lower spinal region. I was achy all over my hips and spine. I could hardly attend my classes, especially since the weather was so cold (it made it 100times worse!). I spoke to my GI, who told me to go to my GP to make sure he didn't see something else going on (like rheumatoid arthritis or ankylosing spondylitis , both of which run in my family). The GP saw the inflammation, but said my symptoms didn't seem bad enough to be either one, so I was prescribed a 12day regimen of prednisone to knock the inflammation down. After that, I saw my GI and he started me on entocort, 9mg a day because my c-reactive was still high, albumin was low, and I was still having some symptoms. It helped, and I was feeling better for a few months. Then about early March, I started becoming really sick again. I started going to the restroom 6+ times a day, having accidents, not waking up from sleep to use the restroom. And then I lost 10 lbs in 2 weeks. I got in to see my GI about 2 weeks ago. I am now on prednisone, starting at 20 mg a day, twice a day, decreasing by 5 mg a week. If this doesn't work, I'll be going on Humira. This is my first time to use the stronger steroids and even speak about using the TNF, so I'm kinda nervous.

Anyways, the main reason I'm writing is this. I am prescribed tramadol for when I really need it. Ever since starting the prednisone, I have had LOTS of constipation (which I guess is better than the alternative). My bms are definitely not regular, going about once every 4 days. The stool is very solid and oh-so painful to pass. I don't even feel like I fully evacuate at all. The pain I feel with this solid stool is much worse than the pain with diarrhea. At least the pain with D is only in the most sensitive areas, but the pain with C is all over my abdominal area. I feel it anywhere from right by my stomach to my colon. And its so sharp. Its like being stabbed in the gut. I don't like taking tramadol though, despite all this pain. I hate both the idea of being reliant on a pain reliever and the way the pain reliever makes me feel. I become lethargic and have trouble with my motor skills. But, with the way the pain is now, I can hardly function. In the past two weeks since starting the prednisone, I've had to miss work twice because I've felt so bad. And my apartment has become a mess! The pain lasts all day, whereas D pain was only for a consecutive hour tops.

I need help getting my bowels to move more efficiently and with less pain! Any suggestions? I'm willing to eat/try anything! I eat only whole wheat items to get fiber, but maybe I'm getting too much? I've been doing stool softeners, but that isn't helping fast enough. And I've tried caffeine, but that doesn't appear to be working as lately it just brings more pain. I've heard peppermint teas work... Any suggestions would be so appreciated. The prednisone, along with the pain, has ruined my sleeping schedule (I can't fall asleep til like midnight, and then I wake up at 4 from pain...never have I been so exhausted!).
23yr old female
Dx w/ Crohns: October 2004
Dx w/ IBS: November 2008
Current medications: Prednisone, 40mg tapering to 0; tramadol, 50mg when needed; hyoscyamine, .125mg when needed; and of course, multivitamins


njmom
Veteran Member


Date Joined Apr 2006
Total Posts : 1884
   Posted 5/23/2010 5:00 AM (GMT -7)   
As my daughter's doc said, once, the good news is the pred must be working if you have constipation.
 
- Oddly enough, yogurt might help, as it helps to regulate the digestive system and so can help with constipation and diarrhea.
 
- And fiber from vegies, as long as they are cooked to the point where they are really soft (as your Crohn's is active and so raw vegies are hard on inflammed intestine).
 
- Also, be sure to stay well hydrated. 
 
- Caffeine irritates the intestines, so not a good idea.
 
- Am not sure if prune juice is OK, but might be worth a try - just one glass in a 24 hour period.
 
What kind of med does the doc plan to have you on after you taper off pred - it's not a good idea to have no meds.
  

Writer
Regular Member


Date Joined Aug 2006
Total Posts : 443
   Posted 5/23/2010 5:22 AM (GMT -7)   
How about trying total enteral nutrition (full liquid diet using meal-replacement drinks designed for this purpose)? It is proven in clinical studies to be effective in inducing remission (like steroids but without the side effects), and also, which would be of particular importance for you, significantly increases intestinal motility. If it works for you, it could have a major effect on relieving the chronic constipation.

Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 5/23/2010 8:04 AM (GMT -7)   
I suffer with more constipation that I do diarrhea. Always been that way for me. I take stool softners nightly in order to keep things softer and easier to pass. They are over the counter, one brand is Colace. These are NOT laxatives, just help to draw the water to your stool to help you pass it easier. I have been using these for years, if I didn't I would be in alot of pain like you are. I do take probiotics and since I got on my newest one, I now only have to use one at night now, instead of the two I was. Give it a shot, maybe it will help some with your pain. Good luck!
Gail*Nanners* Co-Moderator for Crohns Disease 
Crohn's Disease for over 34 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium, Vit D, and Xanax prn. Resections in 2002 & 2005. Also diagnosed w/ Fibromyalgia, Osteoarthritis, & Anxiety. Currently my Crohns is in remission, but my joints are going crazy!
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

Japey
Regular Member


Date Joined May 2010
Total Posts : 29
   Posted 5/23/2010 10:41 AM (GMT -7)   
The doc plans to put me back on a maintenance dose of asacol or entocort if the inflammation goes down; otherwise, we will be trying a TNF. I'm guessing it is, though, cause of the constipation, I've just never had this amount of pain before (nor have I been so constipated in about the past 6 years).

I know prune juice is bad, as I tried it once and it made me extremely gassy. The pain from the gas is just too much. Yogurt has helped me in the past (I think, its hard to tell sometimes). Probiotics are what is in yogurt, right? So, should I take them through yogurt, or are there pills that are recommended? Are certain probiotics better than others? I have a fairly large health food store in town, but its always really intimidating because I never know what I'm looking for.

I was also thinking about doing a liquid diet for a while, until I've passed the food currently in my system, and then introduce food slowly. I want to go about this in a really safe way though. Any readings I can read about a safe liquid diet? Or any recommended brands to get full nutritional value in drink form? I have the ability to make drinks myself if anyone has a list/book of recipes too. I'll also try colace.

Thank you all for your help. Its really good to read what other people go through and to have someone to talk to about this. I've just never been in this much pain, and I need to nip it in the bud. I'm one of only two hostesses at a small local joint, and I can't be missing work. They really need me there.
23yr old female
Dx w/ Crohns: October 2004
Dx w/ IBS: November 2008
Current medications: Prednisone, 40mg tapering to 0; tramadol, 50mg when needed; hyoscyamine, .125mg when needed; and of course, multivitamins


Japey
Regular Member


Date Joined May 2010
Total Posts : 29
   Posted 5/23/2010 11:00 AM (GMT -7)   
I thought I'd add that currently, I have a fairly open diet. I avoid things I know are very problematic, such as lactose and red meats. I also avoid foods high in fat and nuts. I don't drink coffee anymore (I used to when I mostly diarrhea but would get backed up occasionally). I also am now staying away from sodas. I try not to eat a lot of cold items, as that also causes cramping and pain in my stomach (I think that's more related to the IBS). But I have no problems with most other foods. I also enjoy all different types of flavors (all foods of the world), if that helps someone to give me a recipe book. I'm also a fairly competent cook and have a full kitchen at my disposal. (I don't like eating out as its way too expensive and too much I can't control.) I have a feeling that I'm gonna be stuck in this flare-up/painful constipation position for a while, so I better get used to it and start making foods I can enjoy and still eat.

Also, I've tried light yoga-type exercising, but with the prednisone I get way too hot. And getting hot causes my stomach to go into pain. I can't even be outside in the sun for more than 20 minutes without keeling over from it. I'm not looking forward to my electric bill this summer as I live in the south and its already freaking hot here. When I graduate, I'm moving somewhere with mild weather all year round.
23yr old female
Dx w/ Crohns: October 2004
Dx w/ IBS: November 2008
Current medications: Prednisone, 40mg tapering to 0; tramadol, 50mg when needed; hyoscyamine, .125mg when needed; and of course, multivitamins


vixen
Veteran Member


Date Joined Jan 2010
Total Posts : 794
   Posted 5/23/2010 11:54 AM (GMT -7)   
 
Hello Japey,
My son. like you suffers with constipation and like you prior to his diagnosis was eating lots of whole wheat/fibre foods but we were told(after diagnosis) no wholemeal/brown bread, spaghetti etc and minimal fruit and veg. In areas where you may be ulcerated/inflammed these type of foods can do more damage than good.
He went on to enteral nutrition for seven weeks and suddenly had to cope with the big 'D' several times a day-it gave his system a chance to recover though(as well as getting some nutrients) and what with that and various drugs(pentasa/entecort/azathioprine) he is now eating normally and has gained approx 22lb.

florida5
New Member


Date Joined May 2010
Total Posts : 6
   Posted 5/23/2010 11:55 AM (GMT -7)   
I was told to let your intestines rest and drink fluids for a while. I was told Boost was the best thing to drink because it has no fiber in it and it has a lot of vitamins. Hope this helps!

ivy6
Elite Member


Date Joined Sep 2005
Total Posts : 10404
   Posted 5/23/2010 2:29 PM (GMT -7)   
Unfortunately, the Tramadol is going to slow your innards down and may even plug them up. If you can handle it, it might help you to cut back on the pain meds a little (or entirely) and see if that helps you at all. I don't want you to be in huge amounts of pain, though, so only do this if you think you'll be able to cope.

If you are concerned, it might help to talk to your doctor. There are "gentle" laxatives that can be prescribed to help clear you out... but they aren't always entirely pleasant to use, as you can imagine.

Welcome,

Ivy.
Co-Moderator Crohn's Forum.

Medications for Crohn's ~~ Diet and Nutritional Therapy for Crohn's ~~ Dealing with Abscesses and Fistulae ~~


NiceCupOfTea
Veteran Member


Date Joined Jan 2010
Total Posts : 8581
   Posted 5/23/2010 4:50 PM (GMT -7)   
The last time I started a course of prednisone I got constipated on it badly. It didn't last very long, as basically, with prednisone, as soon as I reduce the dose the symptoms come back. However, even without prednisone I've occasionally had bouts of severe constipation. Not caused by pain meds either, as I've never been on pain medication. And for most of this year, I've been tending towards reduced number of stools. (Doesn't mean my Crohn's is better, mind. In fact, the opposite.) I do find that if there is a day when I don't pass any stool at all there is a noticeable increase in pain the next day. When I do go it's usually pure liquid but because I am going much less often I worry about impacting again if I'm not careful.

What I do is try to keep the stool inside as soft as possible by drinking throughout the day - room temperature (better for absorption than ice cold) water, tea, herbal tea in the evening, more water. I also avoid fibre and binding foods to excess, although I do eat some of both. If you're already backed up, then piling on the bran, etc. will make your constipation even worse. By all means go on a temporary liquid diet until the backlog has gone. Milk tends towards being constipating, though, so I'm not sure it's a good idea to drink loads of milk-based products :-/

If I've had a backlog and cleared it, so to speak, I take a ducolax laxative for 2-3 days. It upsets my intestines and sends me running to the toilet again, but better that than constipation tbh. Anyway, that usually seems to "reset" my system and I'm good to go again for a while.

One last thing. Not to be gross or anything, but if you can feel the stool in your rectum but can't pass it because that part of your bowels seems to have seized up, a suppository works well for that. You will hate life for 30-45 minutes but after that there should be an immense sense of relief. Also, raising your knees when sitting on the toilet makes it easier to ease the stool out. If it's large or hard (sorry for TMI) then don't try to push it out all in one go, but relax and your rectum should push it out bit by bit of its own accord with a bit of help from you along the way.

*reads back after last paragraph* Wow. Hope I didn't put anyone off their food with that.

Japey
Regular Member


Date Joined May 2010
Total Posts : 29
   Posted 5/23/2010 5:28 PM (GMT -7)   
TMI is good information! I've been diagnosed for a while now, so I'm used to describing all my different stools. :) I rarely take the tramadol because I hate taking it. The thought of needing a pain reliever to get by is so depressing, that I only take it when absolutely necessary. So, lately I take it maybe 1 pill a week for when its so bad but I need to get out. I don't think its the pain relievers causing constipation.

I'm definitely going to get in more fluids, and I'll try drinking warm herbal teas (I can't drink warm water, especially here as it tastes like the lake it comes from). Do I need to be concerned going on a liquid diet for a day or two? Should I not exceed more than two days? Also, when I do go to the restroom, I have to strain to get it going and sometimes I strain through the whole ordeal. Otherwise, I just feel pressure and it never comes out even if I relax. I've sat on the toilet for 30+ minutes just waiting and waiting until finally I got tired and pushed really hard to get it out. I know that's bad to do though. Anyways, once it is out, I still feel pressure in my rectal area. I often had tenesmus when I had diarrhea, but the feeling to go was higher up in my intestines near my ileum and not right around my rectum. The pressure isn't painful, but more of an annoyance. This might be something I need to talk to my GI about, in case it is a sign of something more.
23yr old female
Dx w/ Crohns: October 2004
Dx w/ IBS: November 2008
Current medications: Prednisone, 40mg tapering to 0; tramadol, 50mg when needed; hyoscyamine, .125mg when needed; and of course, multivitamins


kazbern
Veteran Member


Date Joined May 2010
Total Posts : 8375
   Posted 5/23/2010 5:51 PM (GMT -7)   
Japey, have you tried pentasa yet? I was on asacol for the first couple of years, but I still had some D and other unpleasant things, and switched to pentasa. I think it works on inflammation in the small bowel better than asacol.

You didn't mention in your note about exercise, but a good walk or run might help with the constipation. Also a belly massage - sometimes I can feel my stool in my gut and just gently rubbing clockwise will help things move along.

I am amazed to read about all the folks here who have more C than D - I thought I was the odd one with that. For me, hard stool isn't a problem, but slow bowels - no action for a couple of days usually means a day of cramps, frequent stools and general misery.

Japey
Regular Member


Date Joined May 2010
Total Posts : 29
   Posted 5/23/2010 6:08 PM (GMT -7)   
Kazbern - When I was first diagnosed, I was on pentasa, but that was back in 2004 when I went to a different GI. After my first "remission" and then a new flare-up and new GI, I was put on asacol which worked for a while. Then got into the major flare-up which started this past holiday season and tried entocort which didn't work. Now am on the prednisone. I am only on prednisone right now. As we taper off, I'm going to go back onto either asacol or entocort, dependent on how I'm doing. If I get worse, then I am going to go to Humira.

Normally I do exercise a bit, but mostly yoga/stretching/muscle toning type exercises. When I get hot, especially since I started the prednisone, it causes my stomach to really hurt.

Its really weird for me to have C as I have had D since when I was first diagnosed. I don't think I've ever really had a bad C since then. I only have had slow bms, but not actual hard, dense stools. Before I couldn't go for a few days, but the stool would still be very soft. Right now the stools are extremely dense, like rodent stool, when I am finally able to go.
23yr old female
Dx w/ Crohns: October 2004
Dx w/ IBS: November 2008
Current medications: Prednisone, 40mg tapering to 0; tramadol, 50mg when needed; hyoscyamine, .125mg when needed; and of course, multivitamins


mdf34
Veteran Member


Date Joined Feb 2010
Total Posts : 925
   Posted 5/23/2010 6:17 PM (GMT -7)   
I don't need it, but I hear Plum-Smart juice is pretty good to use.  Not as hard to drink as prune juice, and it does not "hit" you as hard, but will still help you go.  I have it on good authority.
 
Also, yogurts with the active cultures, not activia specifically, have seemed to help me alot..
Diagnosed (FINALLY) UC Sept 09/Diagnosis amended 5-3-10 to Crohn's
Taking Pentasa 500mg/8x/day
Entocort 3X/day
Bentyl as needed
1000 mg Vitamin C
Prilosec 1X/day
Flonase
 
 


NiceCupOfTea
Veteran Member


Date Joined Jan 2010
Total Posts : 8581
   Posted 5/23/2010 6:20 PM (GMT -7)   
Meh. If there's one thing Crohn's has taught me, it's the astonishingly wide variety of stools there are. Even diarrhoea is amazingly varied. It's not just a uniform brown liquid, but many different types of brown liquids :p

I didn't think it was the Tramadol, really. Partly because you only take it occasionally but also because you were taking it before the constipation started.

Herbal teas are good, but I feel like you should drink some plain water if you can (doesn't have to be warm; it just shouldn't be ice-cold). Can you buy bottled water?

I'm not an expert on liquid diets, but going on one for a couple of days should be safe. Any longer than that, though, and you should probably clear it with a doctor.

Are you getting any urges to go? If so you should only try going during an urge. And even then it may not work - the urge may have disappeared by the time you're on the toilet. It's maddening when that happens, especially if you're bloated, uncomfortable and in pain and just want to go. You just have to keep patient; eventually the urges will get strong enough that you will be able to pass the stool. I've had times where I've practically had to coax it out centimetre by centimetre at a time, but more often than not once it starts to come out the rest follows quite easily.

I did find with bad constipation that it would begin with me not having any urges and then, after 2 or 3 days of not going, the urges would kick in and gradually get stronger and stronger. But at the same time my rectum would appear to be inert and incapable of pushing the stool out =/ Difficult one. And luckily something I only rarely get but over several years I have had enough time to learn how to deal with it. It's better to relax completely; don't strain, don't clench anything. Keep your knees raised. Something should start to move. Strain gently to help it along but stop if it's not going any further and relax again. By such tortorous means you should get the stool out.

*reads last two paragraphs* I don't know whether to be embarrassed or proud by the deep-found knowledge of bowels that Crohn's has given me.

Mind, I fall down on the tenesmus part anyway. It's not something I've ever really suffered from. It could be related to inflammation in the rectum, so I would ask your GI about it.

NiceCupOfTea
Veteran Member


Date Joined Jan 2010
Total Posts : 8581
   Posted 5/23/2010 6:23 PM (GMT -7)   
kazbern said...
I am amazed to read about all the folks here who have more C than D - I thought I was the odd one with that. For me, hard stool isn't a problem, but slow bowels - no action for a couple of days usually means a day of cramps, frequent stools and general misery.


With me, I've usually had chronic diarrhoea. It's only this year and some of last year that I've been tending towards slowed transit. And I hate it. Would rather diarrhoea 10x a day than this, tbh :-/

Grandpato2
Veteran Member


Date Joined Dec 2009
Total Posts : 681
   Posted 5/24/2010 12:41 AM (GMT -7)   
Nice cup what laxative do you recommend for a suppository? ducolax? I usually don't ever get constipated but Dr. suggested I try a probiotic called Nu-Zen and the only result I've found from it is constipation. Also why would warm vs cold water affect absorbtion? Most water's absorbed in the colon and it's all warm by then.
Male, 54 years old with Crohn's since 15 years old, diagnosed at age 46. Terminal ileum resected 2002. 5 months of remission. Crohn's has now been active since early 2003. Had a gall bladder removed Nov. of 2009. Currently on Remicade every 8 weeks, Nexium, Iron, B-12 injection every 4 weeks,5-asa Asacol, Morphine Sulfate as needed for pain. Cymbalta for long term pain control. 5-asa Salofalk, Entecort, Imuran and Prednisone in the past.


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 5/24/2010 6:33 AM (GMT -7)   
The stool softners work really well for me. I really think you should give them a try. They help you to go without all the cramps and pain of laxatives. JMHO
Gail*Nanners* Co-Moderator for Crohns Disease 
Crohn's Disease for over 34 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium, Vit D, and Xanax prn. Resections in 2002 & 2005. Also diagnosed w/ Fibromyalgia, Osteoarthritis, & Anxiety. Currently my Crohns is in remission, but my joints are going crazy!
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

Writer
Regular Member


Date Joined Aug 2006
Total Posts : 443
   Posted 5/24/2010 6:46 AM (GMT -7)   
Japey,

In answer to your question if there's anything "I can read about a safe liquid diet," there is a book about enteral nutrition for people with Crohn's disease available through the the HealingWell online bookstore (look in the Crohn's disease category) and through the CCFA online bookstore.

Japey
Regular Member


Date Joined May 2010
Total Posts : 29
   Posted 5/24/2010 10:21 AM (GMT -7)   
Thanks for all the advice. I've started taking off-brand docusate sodium stool softeners and some probiotics. I'm also laying off most solid foods (just white rice for me) and using boost shakes that I drink with soy milk (they seemed to be the least bad based on vitamins and fiber and stuff). Got my vitamins, Gatorade, and prednisone and a new water filter pitcher. I haven't really evacuated my bowels in about 3 days so when I tried to eat breakfast this morning it was very painful. If it gets worse or if I don't go by tomorrow night, I'm gonna go see the doc. I'm still able to have gas and I'm not dying from pain yet. Also I'm not running a fever or vomitting. Hope I get this out before I get a serious blockage. *crosses fingers* I never thought I'd be praying to have diarrhea.
23yr old female
Dx w/ Crohns: October 2004
Dx w/ IBS: November 2008
Current medications: Prednisone, 40mg tapering to 0; tramadol, 50mg when needed; hyoscyamine, .125mg when needed; and of course, multivitamins

Post Edited (Japey) : 5/24/2010 11:26:02 AM (GMT-6)


NiceCupOfTea
Veteran Member


Date Joined Jan 2010
Total Posts : 8581
   Posted 5/25/2010 6:26 PM (GMT -7)   
Grandpato2 - Ducolax should be grand. I wouldn't take suppositories, though, except in emergency situations. They're not pleasant to take...

Water passes through the system miles quicker than food. If it's ice-cold it probably won't have cooled to body temperature by the time it reaches your colon. The body can't use water while it's cold, so it has to expend a certain amount of energy heating it up:

health.howstuffworks.com/question447.htm

That said, ice-cold water is still water and will still supply your body's water needs. But warmer water just feels more readily 'absorbable', even though that's not a very scientific thing to say. Personally, unless the weather is really hot, I find ice-cold water quite hard to stomach.

Japey - Good luck. Do feel for what you're going through, as constipation is more of a misery to me than diarrhoea. Wouldn't eat too much white rice, though, as that's a binding food :-/ (Look up the BRAT diet on google to see what I mean...)
New Topic Post Reply Printable Version
Forum Information
Currently it is Friday, December 09, 2016 10:01 PM (GMT -7)
There are a total of 2,735,737 posts in 301,325 threads.
View Active Threads


Who's Online
This forum has 151428 registered members. Please welcome our newest member, livefreeinhealth.
284 Guest(s), 8 Registered Member(s) are currently online.  Details
Mews2much, geop, Tick41, Sheeks175, Grazzed, Sarakt, Octorobo, Csweeney1002


Follow HealingWell.com on Facebook  Follow HealingWell.com on Twitter  Follow HealingWell.com on Pinterest
Advertisement
Advertisement

©1996-2016 HealingWell.com LLC  All rights reserved.

Advertise | Privacy Policy & Disclaimer