Tag Archives: acupuncture

Straight, No Chaser: Chronic Pain

General Health and Wellness, Neurology, Health Prevention, , , , , , , , , , , , , , , , , , , , , ,

The notion of a pain awareness month is an odd thing; probably even more so to those suffering from chronic pain. Typically the idea with these periods of recognizing diseases and conditions is to create sensitivity among the general public toward one’s condition. In this and the next Straight, No Chaser, we will not only do that but will build upon that and provide those sufferers of chronic pain some better tools to make those emergency room visits more productive.
chronic-pain
I’d begin by asking you to get more in touch with your “you sensitivity” and learn to differentiate between different types of pain. It’s important for you to know the difference.

  • Clearly there’s acute pain from injury. You break a jaw or twist an ankle, you’re going to hurt.
  • There’s acute exacerbations of pain from disease. You have sickle cell anemia? Cancer? Lupus? Sciatica or other low back pain? Arthritis? Migraines? You will have acute flare ups.

Then there’s chronic pain. Remember, sometimes pain happens without injury or disease. Pain is simply a signal communicated from your body to you through your brain. Acute pain is normal and is meant to alert you to somehow protect yourself or get help. Chronic pain is different. Those signals coming from your nervous system can be sporadic or haphazard, and they may be more reflective of dysfunction within the nervous system than a disease or injury. It can even be psychogenic (due to matters of your mind). Regardless of the cause, chronic pain is well, a pain.
There are many established conditions that cause chronic pain, such as the following:

chronicpain-circle3

Maybe the point of this post isn’t to tell those of you who suffer from chronic pain things you don’t already know as much as it is to organize your thoughts and approach to your pain. After all, it’s not like there are cures for chronic pain besides eliminating the underlying condition (which reminds me to remind you not to fall for the many medical scams promising instant and permanent relief to these medical conditions). The first step really is to help you appreciate the need for becoming better sensitized to your condition. Many patients with chronic pain suffer horrible outcomes because they become desensitized to pain, learn to ignore it, and misinterpret a new, unrelated pain condition (maybe with a few similarities), failing to get evaluated before it is too late.
If you suffer from chronic pain, it’s key to know the things you can do to improve your quality of life. Strengthening your mind to reduce stress and avoid fixating on your medical condition is very important. Learning to relax actually is treatment; your body has pain-reducing chemicals, including those that directly treat pain and promote healing, and others that prevent release of internal pain producers. Find someone with whom you can discuss relaxation and stress reduction.

chronicpain2

Engage the fight to get better within your physical limitations.

  • Exercise remains key. Depending on your situation, walking, running, biking and/or swimming can dramatically improve your situation. Be advised that the extremes (not exercising at all or doing so too much) can actually worsen the situation.
  • Stretching and strengthening similarly produce benefits to those with chronic pain. This should sound like a good reason to become involved with a personal trainer or have a physical therapist.
  • Regular sleep and avoidance of nicotine (stop smoking!) will also help.

Your physician may discuss multiple other possible treatment modalities, such as the following:

  • Acupuncture
  • Behavioral therapy can reduce your pain and decrease your stress through methods that help you relax, such as meditation, tai chi, and yoga. Give it a try. It works for many people.
  • Brain stimulation therapy
  • Local electrical stimulation
  • Occupational therapy teaches you how to perform routine activities of daily living in a way that reduces your pain and/or avoids reinjuring yourself.
  • Osteopathic manipulation therapy (OMT)
  • Psychotherapy

Regarding medication, for many people use of medication (especially narcotics) becomes a crutch and a slippery slope. Over the counter medications such as acetaminophen and ibuprofen are quite effective for many causes of pain. Use of narcotics should be measured and part of an overall plan, not a tool for a quick fix or to get you out of your doctor’s face. It is part of reality that even if you are not a drug-seeking patient, with enough exposure to narcotics you will develop tolerance (less effectiveness at the same dose) and become addicted. You should want to avoid this fate.
The pain, mental duress and reduction in quality of life associated with chronic pain can be lessened with you learning how to approach and understand your pain, taking appropriate steps to reduce things you do to exacerbate the pain, increasing the things you do to lessen the pain, and working with your health care team to provide you with appropriate support and treatment.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
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Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Chronic Pain

General Health and Wellness, Neurology, Health Prevention, , , , , , , , , , , , , , , , , , , , ,

Print

The notion of a pain awareness month is an odd thing; probably even more so to those suffering from chronic pain. Typically the idea with these periods of recognizing diseases and conditions is to create sensitivity among the general public toward one’s condition. In this and the next Straight, No Chaser, we will not only do that but will build upon that and provide those sufferers of chronic pain some better tools to make those emergency room visits more productive.
chronic-pain
I’d begin by asking you to get more in touch with your “you sensitivity” and learn to differentiate between different types of pain. It’s important for you to know the difference.

  • Clearly there’s acute pain from injury. You break a jaw or twist an ankle, you’re going to hurt.
  • There’s acute exacerbations of pain from disease. You have sickle cell anemia? Cancer? Lupus? Sciatica or other low back pain? Arthritis? Migraines? You will have acute flare ups.

Then there’s chronic pain. Remember, sometimes pain happens without injury or disease. Pain is simply a signal communicated from your body to you through your brain. Acute pain is normal and is meant to alert you to somehow protect yourself or get help. Chronic pain is different. Those signals coming from your nervous system can be sporadic or haphazard, and they may be more reflective of dysfunction within the nervous system than a disease or injury. It can even be psychogenic (due to matters of your mind). Regardless of the cause, chronic pain is well, a pain.
There are many established conditions that cause chronic pain, such as the following:

chronicpain-circle3

Maybe the point of this post isn’t to tell those of you who suffer from chronic pain things you don’t already know as much as it is to organize your thoughts and approach to your pain. After all, it’s not like there are cures for chronic pain besides eliminating the underlying condition (which reminds me to remind you not to fall for the many medical scams promising instant and permanent relief to these medical conditions). The first step really is to help you appreciate the need for becoming better sensitized to your condition. Many patients with chronic pain suffer horrible outcomes because they become desensitized to pain, learn to ignore it, and misinterpret a new, unrelated pain condition (maybe with a few similarities), failing to get evaluated before it is too late.
If you suffer from chronic pain, it’s key to know the things you can do to improve your quality of life. Strengthening your mind to reduce stress and avoid fixating on your medical condition is very important. Learning to relax actually is treatment; your body has pain-reducing chemicals, including those that directly treat pain and promote healing, and others that prevent release of internal pain producers. Find someone with whom you can discuss relaxation and stress reduction.

chronicpain2

Engage the fight to get better within your physical limitations.

  • Exercise remains key. Depending on your situation, walking, running, biking and/or swimming can dramatically improve your situation. Be advised that the extremes (not exercising at all or doing so too much) can actually worsen the situation.
  • Stretching and strengthening similarly produce benefits to those with chronic pain. This should sound like a good reason to become involved with a personal trainer or have a physical therapist.
  • Regular sleep and avoidance of nicotine (stop smoking!) will also help.

Your physician may discuss multiple other possible treatment modalities, such as the following:

  • Acupuncture
  • Behavioral therapy can reduce your pain and decrease your stress through methods that help you relax, such as meditation, tai chi, and yoga. Give it a try. It works for many people.
  • Brain stimulation therapy
  • Local electrical stimulation
  • Occupational therapy teaches you how to perform routine activities of daily living in a way that reduces your pain and/or avoids reinjuring yourself.
  • Osteopathic manipulation therapy (OMT)
  • Psychotherapy

Regarding medication, for many people use of medication (especially narcotics) becomes a crutch and a slippery slope. Over the counter medications such as acetaminophen and ibuprofen are quite effective for many causes of pain. Use of narcotics should be measured and part of an overall plan, not a tool for a quick fix or to get you out of your doctor’s face. It is part of reality that even if you are not a drug-seeking patient, with enough exposure to narcotics you will develop tolerance (less effectiveness at the same dose) and become addicted. You should want to avoid this fate.
The pain, mental duress and reduction in quality of life associated with chronic pain can be lessened with you learning how to approach and understand your pain, taking appropriate steps to reduce things you do to exacerbate the pain, increasing the things you do to lessen the pain, and working with your health care team to provide you with appropriate support and treatment.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Pain Awareness Month and Your Chronic Pain

General Health and Wellness, , , , , , , , , , , , , , , , , , , , ,

Print

The notion of a pain awareness month is an odd thing; probably even more so to those suffering from chronic pain. Typically the idea with these periods of recognizing diseases and conditions is to create sensitivity among the general public toward one’s condition. In this and the next Straight, No Chaser, we will not only do that but will build upon that and provide those sufferers of chronic pain some better tools to make those emergency room visits more productive.
chronic-pain
I’d begin by asking you to get more in touch with your “you sensitivity” and learn to differentiate between different types of pain. It’s important for you to know the difference.

  • Clearly there’s acute pain from injury. You break a jaw or twist an ankle, you’re going to hurt.
  • There’s acute exacerbations of pain from disease. You have sickle cell anemia? Cancer? Lupus? Sciatica or other low back pain? Arthritis? Migraines? You will have acute flare ups.

Then there’s chronic pain. Remember, sometimes pain happens without injury or disease. Pain is simply a signal communicated from your body to you through your brain. Acute pain is normal and is meant to alert you to somehow protect yourself or get help. Chronic pain is different. Those signals coming from your nervous system can be sporadic or haphazard, and they may be more reflective of dysfunction within the nervous system than a disease or injury. It can even be psychogenic (due to matters of your mind). Regardless of the cause, chronic pain is well, a pain.
There are many established conditions that cause chronic pain, such as the following:

chronicpain-circle3

Maybe the point of this post isn’t to tell those of you who suffer from chronic pain things you don’t already know as much as it is to organize your thoughts and approach to your pain. After all, it’s not like there are cures for chronic pain besides eliminating the underlying condition (which reminds me to remind you not to fall for the many medical scams promising instant and permanent relief to these medical conditions). The first step really is to help you appreciate the need for becoming better sensitized to your condition. Many patients with chronic pain suffer horrible outcomes because they become desensitized to pain, learn to ignore it, and misinterpret a new, unrelated pain condition (maybe with a few similarities), failing to get evaluated before it is too late.
If you suffer from chronic pain, it’s key to know the things you can do to improve your quality of life. Strengthening your mind to reduce stress and avoid fixating on your medical condition is very important. Learning to relax actually is treatment; your body has pain-reducing chemicals, including those that directly treat pain and promote healing, and others that prevent release of internal pain producers. Find someone with whom you can discuss relaxation and stress reduction.

chronicpain2

Engage the fight to get better within your physical limitations.

  • Exercise remains key. Depending on your situation, walking, running, biking and/or swimming can dramatically improve your situation. Be advised that the extremes (not exercising at all or doing so too much) can actually worsen the situation.
  • Stretching and strengthening similarly produce benefits to those with chronic pain. This should sound like a good reason to become involved with a personal trainer or have a physical therapist.
  • Regular sleep and avoidance of nicotine (stop smoking!) will also help.

Your physician may discuss multiple other possible treatment modalities, such as the following:

  • Acupuncture
  • Behavioral therapy can reduce your pain and decrease your stress through methods that help you relax, such as meditation, tai chi, and yoga. Give it a try. It works for many people.
  • Brain stimulation therapy
  • Local electrical stimulation
  • Occupational therapy teaches you how to perform routine activities of daily living in a way that reduces your pain and/or avoids reinjuring yourself.
  • Osteopathic manipulation therapy (OMT)
  • Psychotherapy

Regarding medication, for many people use of medication (especially narcotics) becomes a crutch and a slippery slope. Over the counter medications such as acetaminophen and ibuprofen are quite effective for many causes of pain. Use of narcotics should be measured and part of an overall plan, not a tool for a quick fix or to get you out of your doctor’s face. It is part of reality that even if you are not a drug-seeking patient, with enough exposure to narcotics you will develop tolerance (less effectiveness at the same dose) and become addicted. You should want to avoid this fate.
The pain, mental duress and reduction in quality of life associated with chronic pain can be lessened with you learning how to approach and understand your pain, taking appropriate steps to reduce things you do to exacerbate the pain, increasing the things you do to lessen the pain, and working with your health care team to provide you with appropriate support and treatment.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright, Sterling Initiatives, LLC. 2013-2015
 

Straight, No Chaser: An Introduction to Traditional Chinese Medicine

General Health and Wellness, Public Health, , , , , , ,

Straight, No Chaser recently reviewed the healthcare revolution in Indonesia: the effort to place over 250 million citizens within a universal healthcare plan. While in the midst of that process, one thought I had involved how the process played out in countries with even larger populations, such as China, caring for a population of over a billion.

Traditional Chinese medicine (TCM) has been evolving over thousands of years. Unlike Western medicine, largely formed via the scientific method and what we know as evidence-based medicine, TCM focuses on a more spiritual approach that connects patients with mind, body and earth. The underlying Eastern medicine philosophy on health includes the consideration that the human body is either in sync with or a smaller representation of the universe. Additionally, the energy concept known as Qi speaks to that which flows within us and maintains health. Another set of concepts, yin and yang, speaks to opposing forces within us that when out of harmony (i.e. imbalanced) produce disease (or allow diseases to affect us).
Instead of a predominant focus on external factors (e.g. medicines and surgeries) to correct our illnesses, it can be said that TCM focuses on releasing our body’s proven abilities to fight disease (that’s “Westernspeak;” it may be better described as resynchonizing our harmony within the universe).
Applications of TCM seen in the US include acupuncture, herbal medicine and tai chi. Let’s review these three best known components of TCM.

Acupunctureface

  • Acupuncture. Straight, No Chaser has previously reviewed acupuncture; feel free to review the post for more details. The basis of acupuncture is stimulation of the body (most often with thin metal needles) in a way that releases energy, endogenous hormones and otherwise stimulates the body’s ability to heal itself.

china PDR

  • Chinese herbal medicine. There are thousands of medicines described in the Chinese complement to the US Physician’s Desk Reference, called the Chinese Materia Medica. The Materia Medica discusses use of plants, minerals and animal products in combination and by themselves in ways to heal. You’ll easily identify this concept by reflecting on how use of herbal teas and rehydration drinks have penetrated Western culture.

chinese tai-chi

  • Tai chi. Tai chi uses body movements approximating dance and meditation to produce sharpening of the mind, relaxation and enhanced breathing.

You may neither have thought nor currently care to think about the different directions health care takes between Eastern and Western medicine. It is overly simplistic but not inaccurate to say that Eastern medicine focuses on internal health and Western medicine uses external considerations as a crutch. It is accurate to note the greater tendencies in the West to over- and inappropriately use antibiotics (much of this is consumer and market driven) and to also reflect on the consequences of a healthcare system in the US whose reimbursement policies are more strongly tied to medical and surgical procedures than health prevention and longterm patient outcomes.
According to 2012 life expectancy data from the World Health Organization (WHO), the US ranks #36 in the world with a life expectancy of 79.8 years. China ranks #65, with a life expectancy of 76 years. In case you were wondering, Japan is #1 with a life expectancy of 84.6 years, featuring both similar and distinctive features from TCM. Sierra Leone is last in the world with a life expectancy of just 38 years.
Clearly a system thousands of years old doesn’t need (or care) to ask for validation regarding its safety or efficacy, although it is fair to say many components of TCM are only recently being exposed to the scientific method used in the West to objectively quantify the effectiveness of treatment. It is important to note these general safety and efficacy considerations on the three forms of TCM noted:

  • It you receive acupuncture, it is very important to check that the needles are sterile and not laced with any contaminants or unanticipated drugs.
  • If you use any herbal medicines (Chinese or not), be aware that the quality control considerations of regular medicines aren’t the same, meaning exact dosing can’t be known when you’re using herbs and plants. There are potential consequences for this lack of knowledge consistent with the active medicines found in this herbals, such as drug overdoses, drug-drug interactions and other side effects.
  • If you use Tai chi, you will still need to compliment its use with other considerations. Tai chi has never been purported to be a standalone in the midst of a motor vehicle crash resulting in broken bones or a punctured organ.

The reality of both Eastern and Western medicine is there has been migration one toward the other in ways to complement each system’s prevailing practices. As an example, it is estimated that in the U.S., over 3 million individuals undergo acupuncture each year, and approximately 2.5 million practice tai chi. In this example, knowledge provides options. What you learn may help you.
A future Straight, No Chaser will explore the nature and set up of the Chinese health care system from a public health standpoint.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Would You Consider Acupuncture?

General Health and Wellness, , , , , ,

acupuncture

I will start by saying this about Western medicine. It’s presumption is not that complementary and alternative methods of treatment engaged around world, such as herbals, are ineffective. The premise is that any treatment measure needs thorough research, testing and analysis before approval and adoption. The scientific method simply asks for proof to be established prior to recommending a course of treatment. This approach is taken for your safety. If you appreciate that sentiment, you should understand how and why the practice of complementary and alternative medicine (CAM) is allowed but not necessarily recommended as a first line treatment. Physicians have no stakes in pharmaceutical companies’ profit aspirations; in fact, we’re quite aware of them.
Acupuncture is among the oldest treatment modalities in the world, having been practiced in several Asian countries for thousands of years (most notably China). It’s obvious effectiveness in the Far East has generated a call for it to be subjected to the scientific method to better define how to integrate its use into Western medicine.
Here are some frequently asked questions on acupuncture.
Acupunctureface
What is acupuncture?
Acupuncture is a series of procedures that stimulate various anatomical points of the body. To accomplish that, the skin is penetrated with thin metallic needles. Alternatively, electric stimulation may be used. Theoretically, this stimulation releases internal pain-reducing hormones and other chemicals we use to heal ourselves.
acupunctureback
Why is it used?
The treatment of pain is a pretty big reason for the use of acupuncture, including the following conditions:

  • persistent acute lower back pain
  • headache and migraine
  • chronic pain, particularly neck and back pain
  • joint pain
  • dental pain
  • post-operative pain

Some acupuncturists use acupuncture to treat additional considerations not related to pain, including the following conditions:

  • post-operative nausea and vomiting
  • allergies, including hay fever and eczema
  • fatigue
  • depression and anxiety
  • digestive disorders, including irritable bowel syndrome (IBS)
  • infertility and menstrual disorders
  • insomnia

acupunctureelectrodes
Is it safe?
In the hands of a qualified practitioner, acupuncture is associated with relatively few side effects. However, there are multiple potentially serious consequences if not performed properly, including infections and rupture of organs through puncture. To that end, the U.S. Food and Drug Administration (FDA) requires acupuncture needles to be sterile, nontoxic, and labeled for single use by qualified practitioners.
Is it being used in the U.S.?
According to the National Institutes of Health and a National Health Interview Survey conducted in 2007, over 3 million adults and 150,000 children had used acupuncture in the previous year. That’s one of every 100 people!
How does it work?
This is the answer being sought by current research efforts. Research is investigating methods of actions, appropriate medical indications and performance of different instruments used in the process.
What should I expect from a visit to a qualified acupuncturist?

  • You should expect to provide a picture of your overall health.
  • You should not expect much pain. These needles are hair-thin.
  • You should expect to feel energized or relaxed.
  • You should not expect a medical diagnosis. Acupuncturists are therapists, not physicians.

Most treatments require at least a few weeks of sessions. If you’re a sufferer from chronic pain and are at wit’s end, consider acupuncture. I prefer you did that than become a chronic and habitual user of narcotics.
Feel free to contact your Personal Healthcare Consulltant with any questions you have on this topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Copyright © 2015 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Would You Consider Acupuncture?

General Health and Wellness, Neurology, , , , , ,

acupuncture

I will start by saying this about Western medicine. The presumption is not that complementary and alternative methods of treatment engaged around world, such as herbals, are ineffective. The premise is that any treatment measure needs thorough research, testing and analysis before approval and adoption. The scientific method simply asks for proof to be established prior to recommending a course of treatment. This approach is taken for your safety. If you appreciate that sentiment, you should understand how and why the practice of complementary and alternative medicine (CAM) is allowed but not necessarily recommended as a first line treatment. Physicians have no stakes in pharmaceutical companies’ profit aspirations; in fact, we’re quite aware of them.
Acupuncture is among the oldest treatment modalities in the world, having been practiced in several Asian countries for thousands of years (most notably China). It’s obvious effectiveness in the Far East has generated a call for it to be subjected to the scientific method to better define how to integrate its use into Western medicine.
Here are some frequently asked questions on acupuncture.

Acupunctureface

What is acupuncture?
Acupuncture is a series of procedures that stimulate various anatomical points of the body. To accomplish that, the skin is penetrated with thin metallic needles. Alternatively, electric stimulation may be used. Theoretically, this stimulation releases internal pain-reducing hormones and other chemicals we use to heal ourselves.

acupunctureback

Why is it used?
The treatment of pain is a pretty big reason for the use of acupuncture, including the following conditions:

  • persistent acute lower back pain
  • headache and migraine
  • chronic pain, particularly neck and back pain
  • joint pain
  • dental pain
  • post-operative pain

Some acupuncturists use acupuncture to treat additional considerations not related to pain, including the following conditions:

  • post-operative nausea and vomiting
  • allergies, including hay fever and eczema
  • fatigue
  • depression and anxiety
  • digestive disorders, including irritable bowel syndrome (IBS)
  • infertility and menstrual disorders
  • insomnia

acupunctureelectrodes

Is it safe?
In the hands of a qualified practitioner, acupuncture is associated with relatively few side effects. However, there are multiple potentially serious consequences if not performed properly, including infections and rupture of organs through puncture. To that end, the U.S. Food and Drug Administration (FDA) requires acupuncture needles to be sterile, nontoxic, and labeled for single use by qualified practitioners.
Is it being used in the U.S.?
According to the National Institutes of Health and a National Health Interview Survey conducted in 2007, over 3 million adults and 150,000 children had used acupuncture in the previous year. That’s one of every 100 people!
How does it work?
This is the answer being sought by current research efforts. Research is investigating methods of actions, appropriate medical indications and performance of different instruments used in the process.
What should I expect from a visit to a qualified acupuncturist?

  • You should expect to provide a picture of your overall health.
  • You should not expect much pain. These needles are hair-thin.
  • You should expect to feel energized or relaxed.
  • You should not expect a medical diagnosis. Acupuncturists are therapists, not physicians.

Most treatments require at least a few weeks of sessions. If you’re a sufferer from chronic pain and are at wit’s end, consider acupuncture. I prefer you did that than become a chronic and habitual user of narcotics.
Feel free to contact your Personal Healthcare Consulltant with any questions you have on this topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress