Post Nissen Tongue Dry/Burn and Throat Burn

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biged11543
Regular Member


Date Joined Jul 2012
Total Posts : 42
   Posted 7/19/2012 5:38 PM (GMT -6)   
Hi All,

I am new to this. Just had my Nissen on July 6th, 2012. I'll be 2 weeks out tomorrow. My question is, should I still have a slight throat burn and a very dry and sometimes burning tongue? I've tried baking soda and that seems to work briefly. Any information/similar experiences would be greatly appreciated.

Thanks to All!

Mike

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6934
   Posted 7/19/2012 7:11 PM (GMT -6)   
Hi Mike,
Welcome to the Healing Well yeah yeah yeah Wrapped Club! yeah yeah yeah Were those symptoms you had before the surgery, or are they new ones?  At two weeks out, you're in the thick of healing, and can have many discomforts in your upper GI tract. 
 
Keep in mind that your wrap has become increasingly swollen over these past two weeks, and is nearing peak swelling.  It's very possible that what you're experiencing is related to that.  You could be having food and/or medications held up at the wrap site that is irritating your esophagus.  It can mimic reflux, and cause irritation.
 
Once the swelling begins to go down you'll find things begin to get easier and more comfortable. 
 
Also, if you have symptoms that led you to the surgery, you'll have to wait longer than two weeks to experience relief.  Your upper GI tract has been put through a lot.  It has been revised, and accosted by surgical tools.  It takes time to heal those inflamed tissues, but give them time.  I had lung problems that were brought on by reflux, and it took a full two and a half months for them to begin to show improvement.  I've heard of people taking even longer than that to heal problems created by reflux.
 
Hang in there...try to surrender to your recovery and follow it where it takes you.  If you can go with the flow and relax into your healing, it will be much easier for you.  You can't rush it, so don' try.
 
I don't know if you've seen it already, but if not, here is my early recovery journal:
 
Again, glad you've joined us!
I'm sure others will be by to weigh in on the subject. 
Happy healing!
Denise
Words of wisdom by Eckhart Tolle:
"Whatever you fight, you strengthen, and what you resist, persists.”

“Worry pretends to be necessary but serves no useful purpose”

“Accept - then act. Whatever the present moment contains, accept it as if you had chosen it. Always work with it, not against it.”

biged11543
Regular Member


Date Joined Jul 2012
Total Posts : 42
   Posted 7/19/2012 7:22 PM (GMT -6)   
Denise,

Thanks for the warm welcome. I had the throat burn before surgery though my tongue has never been this dry/burning and white. I'm hoping it's just a result of the surgery and am hopeful it will get better. Have you heard of others with the dry/burning tongue? I hope I didn't create more symptoms by having the surgery. I've researched burning mouth syndrome as well. I hope it's not that either. Again, thank you and I appreciate any info you can provide as well as your words of encouragement!! :-)

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6934
   Posted 7/19/2012 8:03 PM (GMT -6)   
Hi Mike,
I don't think I've heard of it after surgery, but certainly before surgery.  Still, everyone is different, and everyone's recovery is different.
 
Don't jump to any conclusions this soon after your surgery.  This recovery takes at least 6 months for the majority of the healing, and a full year for the rest.  I found improvements even into the second year.
 
The hoarseness I had prior to surgery (that is exacerbated by allergy issues) has taken over 3 years to improve.  This is a long-term process.
 
Just take it a day at at time.  Try to follow your recovery's lead, and go with the flow.  If you're worried about your tongue issue, why not find a top-notch ENT in your area and see if you can get an appointment.  See if your PCP can recommend someone.  That way you might be able to get enough information to allow you to relax into your recovery. 
 
I know how hard it is to have bothersome symptoms that don't resolve right away after surgery.  There's always the fear that you had the procedure for nothing, or as you said, have created new symptoms.
 
Still, at your stage of recovery, I can GUARANTEE that you've created new symptoms.  This is a challenging time in a challeging recovery, and I'm certain you've got lots of discomforts and pains.  It's natural in the early weeks.  Many at your stage of recovery think that they've made a mistake and should never have gotten the surgery.
 
This too, will pass.  Relax, and let your body do its work.  You'll get better, but it'll take time and patience.
Very best wishes,
Denise

biged11543
Regular Member


Date Joined Jul 2012
Total Posts : 42
   Posted 7/19/2012 8:36 PM (GMT -6)   
Denise,

Thank you! Your replies are very informative and comforting and I greatly appreciate it. I think I'm going to take your advice and find a top notch ENT to explore the tongue symptoms further. Again, thank you! I'll keep posting as to my progress and, if okay with you, will reach out to you with any questions I may have.

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6934
   Posted 7/19/2012 8:44 PM (GMT -6)   
Mike,
Of course, I'll do whatever I can to answer questions.  This forum has many very experienced members, so I'm sure if you continue to post, you'll receive lots of support and information.
 
I'll be interested in hearing what you find out from your ENT visit.
Happy healing!  Hang in there...you're in the roughest part of recovery. 
It gets better from here!
Best wishes,
Denise

biged11543
Regular Member


Date Joined Jul 2012
Total Posts : 42
   Posted 7/23/2012 7:33 PM (GMT -6)   
Denise,

So I went back to my Primary Care Physician to see if he could tell me what might be causing my extremely dry mouth, white tongue, sore throat, etc. He said it could be a fungal infection; something I never even thought of. He put me on Diflucan; I took 4 pills but no relief (still have 2 more though I doubt anything will change). I have an Upper GI (Barium Swallow) scheduled for tomorrow morning. I also have a follow-up appt. with my surgeon this Wednesday because I called the office and told them I was getting worse. My original GI doctor said he's never heard of anyone having worse GERD symptoms after surgery. I feel like all of mine are worse....just frustrated. By the way, can the wrap be "undone"?

Mike

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6934
   Posted 7/23/2012 8:50 PM (GMT -6)   
Hi Mike,
At your stage of recovery, you're not in a position to declare your surgery a failure.  Odds are that your wrap is swollen, and therefore tighter than it was meant to be.  Food is being held back and is irritating your esophagus and mimicing reflux.  Keep in mind that your esophagus is a "dumb organ", and interprets all pain as reflux.
 
Things will improve as you heal...patience.
 
Give the Diflucan a little more time.  It may take more than a few days to clear things up,if fungus is the culpret.  I've had thrush (fungal infection) and took a liquid mouth rinse version of Diflucan. 
 
Glad to hear you're getting some testing and will see your surgeon.  There is no reason you should be worrying without getting information about what's going on from your medical providers.
 
Be sure to post how the tests and appointments go.
Good luck!
Denise
Words of wisdom by Eckhart Tolle:
"Whatever you fight, you strengthen, and what you resist, persists.”

“Worry pretends to be necessary but serves no useful purpose”

“Accept - then act. Whatever the present moment contains, accept it as if you had chosen it. Always work with it, not against it.”

biged11543
Regular Member


Date Joined Jul 2012
Total Posts : 42
   Posted 7/24/2012 12:49 PM (GMT -6)   
Hi Denise,

Here is the synopsis of my upper GI (Barium Swallow):

Looks like the wrap is in tact
It's clear that the Barium liquid did NOT "pass" through in to the stomach very well; it actually stayed in my esophagus for quite some time and just lingered. When it did pass through it was very minimal.

Wondering if my wrap is simply too tight or is it just swollen? I'm 18 days out of surgery right now.

Wondering if this is what is causing my throat burn, dry mouth, white tongue? While the upper GI showed no signs of reflux, it's clear that I could have reflux like symptoms due to the fact that anything passed down my esophagus simply stays there for a while.

Think it's too tight of a wrap? Or is it normal to be swelled at day 18?

As always, your responses and information provided is greatly appreciated!!

Mike :-)

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6934
   Posted 7/24/2012 7:17 PM (GMT -6)   
Hi Mike,
At Day 18, pretty much anything is possible.  When we say that the peak swelling is on or about Day 14, that's with the idea that an individual could peak before or after that time.  It's just a rule of thumb.
 
My guess is that swelling is still a factor in what's going on.  As you know, I'm not a doctor, and don't pretend to be.  Still, having experienced the recovery myself as well as working here on the forum for the past 3 and a half years, I've learned a lot.  It's very common for swelling to create swallowing problems.
 
Also, you are very right in your assumption that food, medication, and liquid that is held back by the swollen wrap can mimic reflux perfectly.  I'd guess that you've got quite a lot of irritation going on right now, and yes, I think it could create the symptoms you're experiencing.
 
Everyone's recovery shares certain similarities, but there are also unique reactions that aren't shared by all post-Nissen patients.   Keep in mind that surgeons don't generally recommend introducing bread and steak into the diet until about 8 weeks.  This is precicely because of the swelling that is to be expected.
 
Swelling is also the culprit that creates most bloating issues.  That's why it resolves over time as the swelling reduces.
 
Hang in there...this will improve over time.  There is always a chance that the wrap is too tight, but at Day 18 it's way too soon to determine that fact.  The odds are in favor that the swelling is the problem.
 
Be sure to take your medications carefully...crush and mix with food, and follow with lots of sips of water.  Medications can be especially irritating.  If you're still on liquids and soft foods take smaller sips and bites, and try sipping some water in between meals to keep the swallowing motion going.
 
Try not to panic.  This should start subsiding soon.  Just be thankful that what you're experiencing isn't that nasty reflux you had the surgery to prevent!  A tight wrap can be a very good thing.  Here's hoping you feel better very soon!
Best wishes,
Denise

drtinsac
Regular Member


Date Joined Apr 2012
Total Posts : 454
   Posted 7/24/2012 8:15 PM (GMT -6)   
I also had tongue burning.. the ENT found lots of yeast on the back of my tongue, and I can see a bit of the white stuff on my tongue, and prescribed me 21 days of diflucan. He said that my tongue symptom could be caused by the yeast (candidiasis).

Anyways I'd take that diflucan as directed and see what it does. I am about 9 days into my diflucan and think I've noticed a slight difference, but it's not normal yet.

biged11543
Regular Member


Date Joined Jul 2012
Total Posts : 42
   Posted 7/25/2012 7:40 AM (GMT -6)   
Denise,

As always, thanks for the reply and info. I see my surgeon today to discuss the results of the Upper GI. I know I'm being impatient with this process; it's just very difficult right now, as you are well aware. Not too mention the thrush I'm dealing with. I hope that goes away too. I talked to my Primary Care and she said it could take some time for the thrush to go away. I just took pill number 6 and really don't see much improvement yet. That said, still 8 more pills to go :-). I'm on the 100mg of diflucan for 14 days...sound about right?

Drtinsac,

Thanks for the info. re: the diflucan and yeast. I'm impatient when it comes to medicine and expect results within a few days of taking it. Sounds like this thrush stuff just takes some time to get rid of. If I may ask, what dose of diflucan did your ENT put you on? Is the 100mg? That seems to be the standard.

Thanks,

Mike :-)

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6934
   Posted 7/25/2012 8:13 AM (GMT -6)   
Hi Mike,
I never took the Diflucan orally, so I don't know the pill dosage.  I have a very sensitive stomach, and try to avoid oral meds as much as possible.  Instead, I used the mouth rinse (I guess that's oral, too, but it doesn't make it to the stomach!).  I take a steroid inhaler, and although I rinse my mouth out afterward, every once in a great while, I've gotten thrush.  It's terrible, I know.  Hopefully it clears up soon.  It does take a long time, so don't stress.
 
Good luck with your appointment with the surgeon.  Let us know what he has to say.  That's how we learn here on the forum!
 
Best wishes,
Denise

biged11543
Regular Member


Date Joined Jul 2012
Total Posts : 42
   Posted 7/25/2012 8:17 AM (GMT -6)   
Denise,

Thanks for the reply. I will definitely let you know what the surgeon has to say regarding the Upper GI test. If I can help others here that's great and is why I continue to post :-).

By the way, it just dawned on me last night that it could be my 12 year old retainer that caused the thrush; especially in my weakened state post surgery. To that end, I have stopped wearing it while I am on the diflucan.

I'll post later today on the results of my surgeon appointment!!

Thanks Denise!!

Mike :-)

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6934
   Posted 7/25/2012 8:43 AM (GMT -6)   
Hi Mike,
 
I think you're on to something!   It's a very good idea to ditch the retainer as your mouth heals. I'm sure your doctor would concur, and had he known you were wearing one would very likely have told you to do just that.  If you take all the pills and still are struggling, or even now if you're worried, give your doc a call and see what he/she has to say.  There might be a different route to take, or perhaps a mouth rinse in addition.  He/she may just reassure you that it takes time.
I don't know...just thinking out loud.
 
Good luck!
Denise
Words of wisdom by Eckhart Tolle:
"Whatever you fight, you strengthen, and what you resist, persists.”

“Worry pretends to be necessary but serves no useful purpose”

“Accept - then act. Whatever the present moment contains, accept it as if you had chosen it. Always work with it, not against it.”

biged11543
Regular Member


Date Joined Jul 2012
Total Posts : 42
   Posted 7/25/2012 1:04 PM (GMT -6)   
Denise,

So here is what my surgeon said:

According to the results of the Upper GI, he considers it a "perfect" Nissen
He said the tightness, at this juncture, is a good thing and he would actually be worried if everything was passing straight through
The report showed no reflux

He also prescribed Nystatin (swish and swallow anti-fungal), which I will take in combination with the Diflucan, to rid the thrush.

I feel tremendously better. He said the swelling will subside as will the difficulty swallowing.

He also stated that the esophagus is a "dumb" organ. To that end, now that it feels something "tight" restricting it (i.e. the wrap), it's not sure how to proceed, thus the difficulty swallowing. He also stated that he could provide me with something to "assist" the esophagus with swallowing, thought, at this juncture, doesn't think that is necessary. He said he typically only uses that option if someone literally can't swallow or is regurgitating the majority of things they try to swallow.

The only thing now is to rid my mouth of this thrush and I can continue on the road to recovery.

As always, thank you for all of your responses and information. Greatly appreciated and tremendously helpful.

I will continue to post as I progress and receive feedback from my Dr.'s.

Thanks,

Mike :-)

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6934
   Posted 7/25/2012 8:45 PM (GMT -6)   
Hi Mike,
That's very good news.  It's amazing how just talking things out person-to-person with your surgeon can set your mind at ease.  I'm glad you got the rinse and swallow Nystatin.  Now that you mention it, that's exactly what I used.  I guess my PCP felt it was easier on my stomach than Diflucan. 
 
I figured that you were getting food held up by the swollen wrap.  I often tell people that he esophagus is a "dumb organ"...it also interprets every pain as reflux.  His comment about the swelling confusing the esophagus and making swallowing more difficult is new information for me, and I'll certainly share it again.  That must be the "spasmy" feeling I got during those early healing weeks.
 
I think a Nissen always confuses the esophagus to some degree.  I know when I had a post-Nissen manometry, they said that everything looked fine except there was some unusual swallowing impulses (or whatever they're called) at the wrap site, which is normal after a Nissen.
 
It sounds as if you're definitely headed in the right direction!
Thanks for keeping us informed.  We learn so much from each other!
Happy healing...
Very best wishes,
Denise

biged11543
Regular Member


Date Joined Jul 2012
Total Posts : 42
   Posted 7/26/2012 5:19 PM (GMT -6)   
Denise,

Just wanted to let you know, and hopefully we can share with others too, the barium liquid that I swallowed got "stuck" in the esophagus asa well; it's not just food that gets stuck due to swelling, it can be liquids as well, which, as you know, can cause irritation.

I'm guessing that's why I still have similar symptoms as I did pre-op. I still have the cool menthol feeling in my throat/mouth. Did you ever have that? If so, did that eventually get better for you? If not, have you heard of it. Often times when I breathe in still I feel like I have a shortness of breath. Kind of feels like when your throat/lungs feel when you run outside in the cold weather. Make sense?

Let me know if you've heard of or had the above symptoms and if the barium/liquids getting stuck is common due to the tight wrap. I literally watched the barium linger in my esophagus and very slowly go into my stomach.

Mike :-)

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6934
   Posted 7/26/2012 9:37 PM (GMT -6)   
Hi Mike,
I've definitely heard of liquids being stuck at the wrap site...it was the same diagnosis I got with a barium swallow post-Nissen.  Actually, my wrap is fairly tight, and at three and a half years post-op, I still get some liquid held back...when I drink a lot of cold water all at once I can feel it build up and drain down.  It doesn't really bother me at all, though.  I really think that liquids are held back more than food--probably because I eat food so slowly and chew it so carefully that it doesn't build up the way "chugged" water does.
 
My reflux created dangerously sick lungs, and they didn't get better immediately.  It took a full two and a half months to notice improvement. It was as if they got better overnight at that point, though. Don't be surprised if it takes a good long time for your bothersome symptoms to resolve.  It took more than a few weeks to get that bad, and it'll take longer than that to heal.
 
I have heard of the menthol sensation, but I didn't have it.  The breathing issues were definitely my biggest symptom, and were the reason I went for the surgery.
 
Just take it a day at a time and try not to get too anxious.  This recovery takes a long time and you can't rush it.  Just go with the flow and accept improvements as they come, no matter how long it takes!  It'll happen!  Patience... turn
Thanks again for sharing your experiences and information.  It's very helpful to others looking for answers.
Happy healing!
Denise

biged11543
Regular Member


Date Joined Jul 2012
Total Posts : 42
   Posted 7/27/2012 7:56 PM (GMT -6)   
Hi Denise,

So, an update, I went to an ENT today to get his opinion on my throat. He said, it's not thrush and is just part of life. I thought what on earth? how did two other doctors tell me it was thrush and you just dismiss it as normal and "part of life". Anyhow, rather discouraging to say the least. I'm going to continue my course of diflucan and nystatin as my tongue is still dry, burning, and white. He said, if it were thrush the diflucan would have worked within 3 days. That's contrary to the research I've done and what my GI doc told me; both said it could be 7-14 days to cure thrush.

Also, I'm getting chest pain, behind the breast bone, right in the middle. Is that common?

Also, and a bigger question, I'm now wondering if my symptoms prior to the surgery were really acid reflux? My GI doc told me that the endoscopy he performed pre-op suggested reflux and I definitely had the hiatal hernia. I just wish I would have done the upper GI test prior to surgery; that's the only test that wasn't suggested. I did everything else (i.e., the endoscopy, the swallow test, and the 24 hour ambulatory test).

I'm just really concerned that maybe I should have only had the hernia repair or maybe nothing at all considering I have the exact same symptoms as pre-op. On the other hand, maybe the symptoms are due to the food/liquid lingering in the esophagus. I truly appreciate all your encouragement, info, etc. I really helps!!

Looking forward to hearing your thoughts!!

Mike :-)

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6934
   Posted 7/27/2012 8:17 PM (GMT -6)   
Hi Mike,
You're 3 weeks post-op, and you're spending way too much time worrying.  Everyone has difficulties and quirks at this stage in the game.  In my experience, you would be hard-pressed to find a GI doc to recommend, or surgeon to do a Nissen unless it were, in their opinion, extremely necessary.
 
The symptoms that sent you to surgery and all the prerequisite tests were a long-term problem, and you're not going to get rid of them in three weeks.  In addition, you're experiencing other symptoms as a result of normal post-op recovery.
 
This surgery takes a full 6 months for most of the healing and a full year for the rest.  You're at week 3.  Yes, indeed, you can be getting very uncomfortable and even reflux-like symptoms from food, drink, and medication that are held up by the wrap site.  The pain behind your breast bone is pretty much right where the wrap is located. 
 
Remember that although you only have 5 little slits, you've had MAJOR, MAJOR surgery inside.  It's extremely common to have pains and continued "reflux" symptoms.  Remember that your surgeon told you that the esophagus is a "dumb organ", and that dumb organ has been through a huge trauma.  It will take time for it to heal and adjust to the major changes that have been made in your upper GI tract.
 
So what to do?  You've done all you can at this point.  You've seen your surgeon and an ENT.  Now all you can do is wait.  You can't rush this, you can only surrender to it and follow the path it takes. Worry and second-guessing your decision are counter-productive and will not do a thing to improve your situation.
 
It took me 6 years and two GI docs to convince one of them to refer me to a surgeon, because he didn't think my reflux was bad enough and was certain it wasn't causing my lung problems.  GI docs and surgeons don't like to do this surgery unless they think a patient is a great candidate.  I rather doubt you would have found ultimate relief without the wrap. 
 
So try to relax and surrender to your recovery. Don't stop asking questions.  If you're worried about something, or want some advice and support, keep posting.  I'm not trying to dissuade you from doing that.  It's just that I think you're driving yourself crazy with worrying and second guessing yourself, and I'm trying to calm you down!  Believe me, I've been there, done that!  We all have.
 
Have a great night!
Happy healing...
Denise
 

biged11543
Regular Member


Date Joined Jul 2012
Total Posts : 42
   Posted 7/28/2012 7:47 AM (GMT -6)   
Denise,

Thank you so much for your email. You're absolutely right, I've done everything I can at this point. All of your information and encouragement have been extremely helpful. I will do my best to let the recovery take its course; multiple doctors have told me everything is okay. I guess I just have to understand that my body has had a MAJOR revision and I need to let it heal accordingly. I will continue to post my recovery experiences as I hope I can be as helpful to others as you have been to me.

And, I promise, I won't stop asking questions :-).

Thanks Denise!!!!

Mike :-)

biged11543
Regular Member


Date Joined Jul 2012
Total Posts : 42
   Posted 7/28/2012 7:50 AM (GMT -6)   
Denise,

Thank you so much for your email. You're absolutely right, I've done everything I can at this point. All of your information and encouragement have been extremely helpful. I will do my best to let the recovery take its course; multiple doctors have told me everything is okay. I guess I just have to understand that my body has had a MAJOR revision and I need to let it heal accordingly. I will continue to post my recovery experiences as I hope I can be as helpful to others as you have been to me.

And, I promise, I won't stop asking questions :-).

Thanks Denise!!!!

Mike :-)

biged11543
Regular Member


Date Joined Jul 2012
Total Posts : 42
   Posted 7/31/2012 7:48 AM (GMT -6)   
Hi Denise,

Just a quick update. So my original GI doc was confused/upset at the primary care physicians for not performing a culture on my tongue. He didn't understand how they could 100% diagnose me with thrush without testing. Anyhow, he agreed to see me next week to perform and endoscopy. He assured me that he will culture my throat and tongue to see if what I have is in fact thrush. I also asked him if I really had GERD prior to surgery and his response was "definitely". All the tests showed it.

Based on previous posts, I'm guessing, given my LPR issues, some of the white burning tongue could be from the food getting stuck at the wrap site, and just lingering there. It probably causes quite a mess down there and as a result the white burning tongue. If that's the case, so be it and, in time, i'm sure my swelling will go down.

Any thoughts/comments. Always nice to get your perspective on things.

Thanks Denise!!

Mike :-)

Baza
Regular Member


Date Joined Jan 2011
Total Posts : 439
   Posted 7/31/2012 8:56 AM (GMT -6)   
Hi Mike,just read your post there,sorry i missed it earlier,i had nissen done in early march and from the surgery i too have had a white tongue,tried everthing and cant shift it.I think its something to do with a tight wrap,im still having swallowing problems with food and liquids being held up and causing something to create a white tongue ie bacteria.im only guessing but doctors cant give me an answer and i never had this before the surgery.Hopefully when your swelling goes down and foods go through more easily it will clear up,thats what im hoping for! Barry
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