Wednesday, December 31, 2008

“Only as high as I reach can I grow, only as far as I seek can I go, only as deep as I look can I see, only as much as I dream can I be."

I've sent this post to be part of How to Cope with Pain's last blog carnival for 2008. However with so much happening I left it too late to be included. However I encourage you to click on this blog title for the link and see what others have to offer.

This Karen Raven quote holds true for people with chronic pain.

Life, as they say, is not a rehearsal. We get one go at it. The choices we make direct out path in life. I choose happiness.


Laughter triggers the release of endorphins, the body's natural pain killers, and produces a general sense of well-being. The threshold of pain is raised during and for a short period of time after laughter.

Laughter also engages various parts of the brain. Perhaps this is one reason people often find that a good dose of laughter can be followed by a burst of creativity.

We know that by making positive affirmations pain perception can be reduced by up to an amazing two thirds.
(Conversely, you can actually increase pain perception by focusing on negative aspects and fearing your pain.)

These findings make perfect sense to me. I know when I talk about how I'm feeling, I feel worse. When I'm having fun I feel better. Now I know I can actually change the inputs which bring about a change in the brain, I'll be more aware of how I think and feel. I'll also be dedicating more time to "actively seeking happiness" and strive to see "the glass half full."

I encourage you to expand your knowledge, reach to grow. Only by seeking information can you go forward. By looking the way will become clear. I encourage you to dare to dream of a better life. "As much as I dream can I be".

Go to "crps/rsd related articles" to the left of this blog and click on the direct link to the article, "Natural Born Pain killers" in Prevention.com. that explains the research behind this thinking.

Sunday, December 28, 2008

Meditation reduces stress, eases pain. Check out Scenic Video's new meditation offerings on their own Utube channel.

Jay of Scenic Videos is now producing videos for quiet meditation. His videos are quality productions. I recommend you watch "Sunset over the ocean" a video in high definition filmed in Newport Rhode Island. The great thing about Jay is that he offers to make a video to suit your needs. This is his Winter Waterfall Relaxation Meditation video.

Click on the title of this blog to go to Scenic Video's Utube channel. Recommended!


Now the festivities are over and many will be feeling the consequences of overdoing it and paying for it later, it's time to remember what helps.

With CRPS/RSD I have learned to take one day at a time. Many things have helped in in my journey to wellness, the most significant of these being Mirror Visual Feedback.

Having breaks between major flare ups is a blessing and an indication that I'm on the right path. Here are some of the things I've found to help with pain and symptoms.

  • when doing mirror therapy pay attention to the location of most pain.(July 07)
  • if pain returns after mirror therapy has relieved the pain, look for underlying problem (October 07)
  • essential oils (still experimenting but amazed so far)
  • breathing out twice as long as in (August) I now do it for a few minutes 5 times a day instaed of once for 15 minutes.
  • resperate machine could be used to control breathing(November)
  • distraction (September archives)
  • magnesium for muscle spasm (September)
  • fish/fish oil for inflamation (September)
  • beetroot for liver protection and antidepressant (September)
  • isometric exercises to reduce pain (September)
  • epson salts warm bath (September)
  • chili cream (capsaicin)
  • heat pack (September)
  • graduated repetition of movements (September)
  • pacing
  • move it or lose it - Bollywood dancing (of sorts) August 07
  • deflated ball gives a great massage (see photo Sept)
  • butterball bath bomb (Sept)
  • water relaxes, calms,slows and improves breathing, helps sleep (Sept)
  • Caring Doctors (Sept)
  • Letting go of worries and avoiding stress (Oct)
  • Actively seeking happiness (Oct)
  • I will take vitamin C if I must have surgery as a precaution. (Nov)
  • eat nutrient rich antioxidant foods. Eas smart. (Nov)
  • use Prantal powder for hyperhydrosis (Nov)
  • make a list what works for me as a quick reference. (Nov)
  • don't despare when I have flare up. Refer to the list. (Nov)
  • Doing the same movement in different ways to reinforce that "it's ok"
  • Following a dental procedure which works for me (Nov)
  • Changing thinking, not "what can be done for me" but "what I can do for myself" (Nov)
  • Eating smart - increasing antioxidants especially vitamin C in my diet. (January )
  • Eating smart - making sure I eat a variety of high antioxidant foods including vitamin C. (March 07)
  • Taking the "glass half full" approach (October)
  • Yamamoto neuro-acupuncture (Nov 07)
  • laser acupuncture mirrors
  • alternate nostril breathing (October 08)
  • Understanding that while it hurts it's not necessarily harmful!!!

I am a sufferer not a professional. These things work for me about which I am very thankful. If you think something may help you check first with your treating practitioners.

Saturday, December 27, 2008

In December 2006, to our amazement Doc, our stumpy tailed cattle dog, added his decoration to our tree.

Thanks to "Cat" for sending me this. It reminds me of when Doc decorated our tree with his broken tennis ball.


Wednesday, December 24, 2008

Doc wasn't sure about the train under the tree. He watched and he watched until it got the better of him and he flattened it with a paw.
I hope you all have a lovely holiday season and that 2009 is a better year for everyone.

Sunday, December 21, 2008

Eating smart - a matter of choices.

Better health Victorian Government article says "phytochemicals found in plants and zoochemicals found in animal products are believed to have greater antioxidant effects than either vitamins or minerals.

Wheat is the most important cereal crop in the world and in its natural unrefined state, features a host of important nutrients. Dr R H Liu of Cornell University, New York, reported that, "whole wheat contains many powerful phytonutrients". Bound phytochemicals were the major contributors to the total antioxidant value.

Phenols, unique phytonutrients found in prunes, are damage preventing substances effective in neutralizing a particularly dangerous oxygen radical. An excellent source of beta carotene, prunes help prevent oxygen based damage to fats. As well as these benefits, potassium in prunes lowers blood pressure and fiber helps to normalize blood sugar.

Sunsweet Dry Fruits note that a recent study from Tufts University in Boston "ranked the antioxidant value of commonly eaten fruits and vegetables using an analysis called ORAC (Oxygen Radical Absorbency Capacity). Prunes topped the list with more than twice the antioxidant capacity as other high-scoring fruits such as blueberries and rasins."

wholefoods.org has heaps of information and recipes. The link is to the left of this blog under "articles of interest".

Keeping it simple and enjoyable.

Well I've decided that if I'm going to eat smart it's going to have to be simple and do able and also enjoyable. I won't stick at something if I don't enjoy it.

We've all heard of the health benefits of tea. Flavonoids are a special group of antioxidant phytochemicals found in black and green tea and adding milk doesn't alter the benefit.


It is worth being aware that drinking tea with a meal interfers with the iron intake from foods of plant origin so it is probably better to drink tea between meals.


I've decided that some traditions are worth upholding. For me the tradition of taking tea and enjoying the experience of tea is worth cultivating. So to do this I've searched for a two cup tea pot that pours without dribbling. I have a favourite cup (or two) and a small jug for milk.

I make tea and find a comfortable place to pour and sip and enjoy. I love company and a cuppa is great shared.

I'm lucky that our local tea is lower in caffeine so I can enjoy without problems. I actually think the enjoyable experience of tea for me out weighs the negative impact on pain of the caffeine.

Saturday, December 20, 2008

Vitamin C reduces the prevalence of complex regional pain syndrome after wrist fracture and more.

This is of particular interest to me as, had this information been known at the time of my wrist fracture in 1998, this simple, inexpensive treatment could have prevented my ten years of pain.
  • The Lancet in December 1999 reported that doctors at Leyenburg Hospital, The Hague, The Netherlands in a prospective, double-blind study showed that vitamin C was associated with a lower risk of RSD after wrist fractures. They hypothesized that this beneficial effect of prophylaxis would be useful in other forms of trauma.


  • Pub Med reported that Researchers at Centre Hospitalier, Rue Marcellin Berthelot, 02 000 Laon, France found that the incidence of reflex sympathetic dystrophy was five time times lower in a group give vitamin C orally for 45 days from the start of the fracture. They considered that this supported previous observations and lent credibility to the value of vitamin C administration as a prophylactic measure to prevent the occurrence of reflex sympathetic dystrophy in patients who undergo surgical treatment of a displaced fracture of the distal radius.

  • In July 2007 the Journal of Bone & Joint Surgery reported that Drs Zollinger, Tuinebreijer, Breederveld and Kreis, Department of Surgery, Red Cross Hospital, Beverwijk, The Netherlands had conducted a randomized, controlled, multicenter dose-response study into whether vitamin C can prevent the development of Complex Regional Pain Syndrome in patients with wrist fractures. The study concluded that Vitamin C reduces the prevalence of complex regional pain syndrome after wrist fractures. A daily dose of 500 mg for fifty days was recommended recommended. This was later changed to 1000mg.
To read more go to the link to the left of this blog under "crps/rsd related articles" or click on the "vitamin C" tag to the left of this blog.

Friday, December 19, 2008

What do anti-oxidants have to do with CRPS/RSD?

First suggested by Sudeck in 1942, Dutch researchers' studies supported the theory that oxygen derived free radicals are possibly the mediators of mechanisms leading to some of the neurological symptoms of CRPS. They found
  • high oxygen supply with tissue hypoxia in CRPS extremities;
  • a diminished oxygen availability to the skeletal muscle tissue affected by chronic CRPS;
  • and several deficiencies in the skeletal muscles of CRPS sufferers.
Studies in Holland have centered around free radical scavengers as treatment for CRPS. There are many ongoing studies with DMSO, NAC in Holland.

Free radicals are atoms or groups of atoms with an odd number of electrons and can be formed when oxygen interacts with certain molecules. Once formed these highly reactive radicals can start a chain reaction. Their chief danger comes from the damage they can do when they react with important cellular components such as DNA, or the cell membrane. To prevent free radical damage the body has a defense system of antioxidants.

Antioxidants are molecules which can safely interact with free radicals and terminate the chain reaction before vital molecules are damaged. Although there are several enzyme systems within the body that scavenge free radicals, the principle micronutrient (vitamin) antioxidants are vitamin E, beta-carotene, and vitamin C. Additionally, selenium, a trace metal that is required for proper function of one of the body's antioxidant enzyme systems, is sometimes included in this category. The body cannot manufacture these micronutrients so they must be supplied in the diet.

Vitamin E : nuts, seeds, vegetable and fish oils, whole grains (esp. wheat germ), fortified cereals, and apricots.

Vitamin C : Ascorbic acid is a water soluble vitamin present in citrus fruits and juices, green peppers, cabbage, spinach, broccoli, kale, cantaloupe, kiwi, and strawberries.

Beta-carotene is a precursor to vitamin A (retinol) and is present in liver, egg yolk, milk, butter, spinach, carrots, squash, broccoli, yams, tomato, cantaloupe, peaches, and grains. (NOTE: Vitamin A has no antioxidant properties and can be quite toxic when taken in excess.)

Research now shows that we can substantially affect the level of anti-oxidants in our bodies by eating fresh fruits and vegetables.

Google "antioxidants for crps" to learn more.

Thursday, December 18, 2008

We all benefit by doing something for others.


Australian singer/songwriter writer Kate Miller-Heidke performed at an historical concert at Angkor Wat temple in Cambodia. Organised by MTV EXIT, it was the first ever rock concert to take place at the ancient temple, and was held to spread awareness of the plight of victims of human trafficking.

Kate's website quotes her as saying, "The setting was magical and timeless as soon as the music started, all these Khmers came out of the forest and were dancing under the stars."
http://www.katemillerheidke.com/contact/home.do

What I have noticed is that people in pain are compassionate. At this time of year it's good to remember those less fortunate.

Monday, December 15, 2008

These tiny flowers and orchids along the track.



"And orchids deck the tree tops"
Dorothea Mackeller - My Country

Minion Falls


This is Minion Falls yesterday, a short drive from Byron Bay.
Perfect for a picnic.
Taking time out for happiness.

Saturday, December 13, 2008

There's nothing like a little good fortune to lift our spirits.

As there is a global recession we could all do with a little good fortune. Today I'd like to tell you about two competitions.
  • How to Cope with Pain is giving us the chance to win prizes by singing up for email posts. I singed up a long time ago as I like to keep informed and the posts are so helpful. http://www.howtocopewithpain.org/
  • Tony Tobin posted recently on his website about a fantastic competition to raise funds in support of a pediatric cardiac unit at Great Ormon Hospital. For the price of a 4GB MP4 player for £60 complete with full warranty,
    you receive free entry into the prize draw. Entrants have a one in 200,000
    chance of winning - and never having to work again.
    Those are very good odds and for a brilliant cause plus you actually get something for your money. The Brits have style. Remember it was a UK pharmaceutical firm, Pann Pharmaceuticals, that donated mirror boxes to pain clinics through Britian. Here's the link to Tony's post. http://www.anthonytobin.co.uk/

Wednesday, December 10, 2008

Care to swap your painful body for a fit pain free one?

A new friend of mine from my web-site Stephen Monaco who lives in S. Cal. found an article on a recent experiment and sent it to me. Thanks heaps Stephen. Stephen gets my new posts in his email. If he clicks "reply" he is able to email me personally. If interested just click on
Subscribe to crps/rsd a better life by Email at the top of this blog.

Yahoo news reported on a brilliant piece of Swedish research "exploring how people can be tricked into the false perception of owning another body."Technology involving wearing goggles has enabled people to experience the illusion of changing bodies.

When Stephen saw this it occurred to him that it might have something to do with the brain retrain stuff I've been posting about. Well Stephen I believe you are very perceptive. I've posted before about the Interfaces Goup in the UK who have stopped phantom limb pain using virtual realaty. You might remember my post (and How to Cope with Pain's) about the virtual snow dome which eases the pain of having burns redressed. Now this idea of swapping bodies has real potential for easing pain by retraining the brain. I had been thinkiong of using virtual reality to project your body in front of you. Using goggles and our own movements the virtual body could be seen to move befor eyour eyes. The illusion would be that the body moves freely without pain. Now if you put the body swap idea together with your own body projection idea there could be hope for pains that are hard to treat with mirror therapy such as back pain. There is also research to support benefits of visualizing movements. The is the ultimate visualization.

Click on the post title for the link to the article. I also encourage you to click on the slide show which shows pictures of just what they did in the experiment.

Wednesday, December 03, 2008

What's in a name? - Not all mirror therapy's the same.

If you google "mirror therapy" you come up with a range of therapies all calling themselves "mirror therapy". Some mirror therapy has been developed to combat body image problems and involves face on examination of yourself in a mirror and "telling yourself" that this or that body part is OK. This, I believe, is a form of training and psychologically based.

It is not the same as the mirror therapy which was invented by Vilayanur S Ramachandran (see link to left of page) to help alleviate "phantom limb" pain. Further studies in the UK and in Australia have proven this type of mirror therapy to help allieviate the pain and symptoms of complex regional pain syndrome. Just as the brain keeps responding with pain messages in the case of phantom limb so too does the brain send pain and pain response messages in the case of CRPS. These messages are not in response to something being wrong (eg dropping a hammer on your foot). The messages are brain driven or created in the brain in the same way as the brain creates the message to tell you heart to beat. You cannot consciously tell your heart to stop beating any more than you can tell yourself to stop the pain. It isn't just pain messages that the brain sends out in CRPS, it's protective messages because of pain eg inflammation, swelling, sweating, vascular messages, colour and temperature changes. These things are under the control of the autonomic nervous system - out of our conscious control.

It hurts and our learned behaviour is to protect the hurting part by stopping things touching it and moving less or resting. This is the best thing to do if the pain was from an injury but it's not. I know that I need to override the normal pain response and move normally and not protect the hurt part. It isn't easy. That's where the mirrors come in. The brain message is wrong. I cannot take pain medicine but even if I could I'd only be treating the symptoms of pain not the cause. The cause is these false messages. By looking at the mirror image of the body part opposite to the one that hurts moving, the brain gets visual stimulus of a moving pain free limb. The brain is being retrained. For me there is usually no instant difference. About 10 minutes after I've finished I notice that I don't feel quite as bad. I do it again and again. It takes effort and I need to keep doing it for several days or weeks. I treat each flare up immediately before it spreads (as it very quickly does for me). Doing this gives the best result. When the pain stops, it is gone for good. If the pain is in the same place again, I know something has triggered it and follow the same process again.
Mirror therapy isn't the whole answer.

  • I do physical therapy every day in small amounts throughout the day. Physical therapy is essential to regain lost function. I try not to over do it (very hard).
  • I do mirror therapy for one sided flare ups. I do it for a short time and several times a day until pain resolves.
  • I breath out twice as long as in for 15 minutes every day to activate the parasympathetic nervous system. I've changed this to alternate nostril breathing with out breath longer than in. I do this for 5 minutes about 5 times a day.
  • I have laser acupuncture and use self hypnosis. I sometimes have Yamamoto New Scalp Acupuncture which stops migraine, settles tendinitis and normalizes the autonomic nervous system.
  • I eat foods high in antioxidants (prunes are highest) to deal with the free radicals caused by stress of coping with CRPS. I "tweaked" my diet so that I have more antioxidants especially Vitamin C. Vitamin C demolishes the free radicals involved in inflammation.After a knee injury I took 1000mg of vitamin C as well as an increase in vitamin rich foods.
  • I refer to my list of things that work for me when I have flare ups.

My plan is to persist until the symptoms of CRPS resolve. CRPS symptoms, specially dysautonomia had resolved earlier this year. However I had an accident in which I injured my knee. Immediately dysautonomia returned as did other problems. However as I took vitamin C immediately and continue to do so, I have no CRPS in the injured knee.

If interested look through my blog under archives to see explanations of what I do and photos. Click on tags under posts to bring up other posts on that topic.

Tuesday, December 02, 2008


Last night I took this photo. Two bright planets in our solar system, Venus and Jupiter, have aligned with the moon creating a rarely seen face formation. Moon represents emotions, Venus love and belonging and Jupiter the need to expand. I hope your universe is filled with love and belonging, your emotions are happy and your horizons expanding.

Sunday, November 30, 2008

Aqua therapy my way - still loving it!

Porta Spa offers a soft, less expensive alternative way for relaxation and ease of movement.

I'm reposting this. My Porta Spa is 12 months old now and good as new. Last winter I'd soak in the hot water before going to bed. Many with complex regional pain syndrome will know what I mean when I say if you get cold you are cold to the bone and it's very hard to get warm again. Immersing in the hot spa warms and relaxes, eases pain and helps me get to sleep.

We are in summer now so I've turned the temperature down. I exercise in the spa using a pool noodle cut like dumb bells. The bubbles aren't harsh but give a gentle massage. I just love it!


As you are probably aware I love water so when a Porta Spa was advertised in a Christmas catalogue I did some investigating. I was a bit nervous as to whether a blow up spa would be sturdy and would last. However we bought one and I absolutely love it. It heats and blows hundreds of bubbles like a normal spa but is soft to sit in. It's made of the same kind of material as white water rafting boats so is very sturdy. Ours is inflated with the pump in minutes and can be deflated and moved or put away. We use an alternative to harsh chemicals which is added each day. This means we don't have a strong chlorine smell and it's kinder on clothes I think.

What this means for me is that I can have the benefits of being immersed in water without having to fill a tub (we're water conscious in Australia). It's big enough for me to float and move and exercise and the bubbles aren't harsh but keep the water moving over my skin which is great for desensitization. In winter I will be able to get warm everywhere and then rug up warmly. If I just rug up I find my extremities remain cold.


For any Australians reading this I found this spa in a Target catalogue for A$699. I've recently seen it for $599. Yes I couldn't believe it either. The local pool shops sell it for about A$2500. When I was searching for information I discovered it's available in the UK and the USA. As Kath from Kath & Kim would say, "I'm just loving myself with my new spa".

Aqua therapy - makes it easier to "move it, move it" despite the pain.

I talk a lot about the need to move normally and to retrain the brain with the "ok" message. An excellent way to do this is with Aqua Therapy. Tony Tobin who owns the UK Yahoo Group RSD/CRPS World News Group http://health.groups.yahoo.com/group/RSD-WorldNews/
is a great advocate for Aqua Therapy. He attributes it as playing a major part in helping his grand daughter go into remission from CRPS. Tony was interviewed on How to Cope with Pain website. http://www.howtocopewithpain.org/blog/93/how-pain-affects-families-a-grandfathers-story/
I encourage you to read his interview and join his news group. Tony is dedicated to posting the latest in RSD/CRPS News and especially research.

International Research Foundation for RSD/CRPS has information on WATSU which is a combination of aqua therapy and gentle exercises. It also has a free video on "Reflex Sympathetic Dystrophy in Children". This video does not mention the new brain science but does recognize as essential to have "normal use" of your body.

American RSDHope has a section explaining Aqua Therapy and Reflex Sympatetic Dystrophy Association (RSDSA) has an section on it's website answering questions about Aqua Therapy. Parc Promoting Awareness has a section on there website also. You'll find the links for this uncer CRPS/RSD related links to the left of this page.

Unfortunately the only link I was able to find on research about Aqua Therapy specifically for the treatment of CRPS was this this link to the Clinical Journal of Pain about the Short and Longterm outcomes of
Children with Complex Regional Pain Syndrome Type 1 Treated with Exercise Therapy http://www.clinicalpain.com/pt/re/clnjpain/abstract.00002508-199909000-00009.htm;jsessionid=HVsDfydTSPF4Dwfjc8ylQNp80zNy7tqB53D3gcp5JG3LT7f7vRX3!-830841920!181195629!8091!-1

Tuesday, November 25, 2008

Let me introduce to you "The Blog Doctor".

Making this blog has been wonderful for me in so many ways.
  • It helps me keep focused on what helps me with pain and symptoms of a chronic pain syndrome.
  • It's a brilliant distraction from pain.
  • The creativity benefits are good for my brain.
  • It keeps me positive.
  • It gives me satisfaction that I am doing something for myself that may also help others.
  • It makes me happy.
One person who has made my task easier and who gives me inspiration is Vin who has the fantastic website The Blog Doctor - AKA Betablogger 4 Dummies. Apart from the huge amount of "how to" information on his site Vin will answer any questions and help you solve problems.

I subscribe to Vin's email posts so I can keep reminded of his great suggestions for improving my blog. I encourage others to consider starting a blog. Blogger has a simple guide for creating blogs and if you bookmark Vin's website you will always have help on hand when you need it.

Click on the title of this post for the link or click here to visit The Blog Doctor .http://www.blogdoctor.me/

Sunday, November 23, 2008

Practitioners using the new brain science treatments in Philadelphia/NJ.

If someone is in the Philadelphia/NJ area, they can contact How to Cope with Pain, and while the medical specialist there doesn't refer to herself through her blog, the doctor can point you to a few other providers who use this type of treatment in that area.

Click on the post title to go to the How to Cope with Pain website.

Saturday, November 22, 2008

Finding practitioners and teachers who use the new brain science approach can be daunting.

In response to Barbara's recent question about how to find practitioners or teachers of the new brain science methods such as mirror therapy, I have been searching for a directory listing possible therapists. I contacted the NOI Group about this some time ago. Even here in Australia the is no register. In my own experience I've found physiotherapists who have had training with Dr Lorimer Moseley and yet do not use the methods in practice. So having a list of trained practitioners will not necessarily guarantee they put into practice what they've learned.

However the NOI Group, Neuro Orthopedic Institute of Australasia,
http://www.noigroup.com/ provides wonderful resources which you can access directly from them on line. Click here for a list of resources including graded motor imagery, limb laterality recognition software, and neurodynamic techniques dvd.
http://www.noigroup.com/ProductList.php?searchfilter=

NOI Group has courses in 2009 in the USA

Mobilization of the Nervous System Chicago, IL Robert Johnson
14-15 March, 2009
Mobilization of the Nervous System Elkridge, MD Adriaan Louw
28-29 March, 2009
Mobilization of the Nervous System ST. Louis, MO Adriaan Louw
4-5 April, 2009
Mobilization of the Nervous System Las Vagus, NV Adriaan Louw
6-7 June, 2009

I suggest if you are interested in finding a practitioner who uses these methods that you print out my post and other information from previous posts. I then suggest you speak with your physical therapist or pain management clinic. Ask them if they are aware of the new understanding of brain plasticity and how it relates to pain management. Encourage them to go to training if in their area. Don't think less of them if they don't know as no one can be expected to know everything. Provide them with information and links to research. Encourage them to find out more and so you can work out what to do together.

Many practitioners will be too busy or disinclined to help. If that happens then you can access the NOI Group materials yourselves. "Explain Pain" is a good beginning as it explains very simply about pain and the brain.
Read about mirror therapy and work it out for yourself as I did. Tell your practitioner what you plan to do and get any advice. They can help even if they don't really know much about it. Our Aussie dollar is very low compared with the US dollar. This will make buying resources from Australia very cheap.

I'm giving you the link to the American Association of Intergrative Medical Practitioners.
http://www.aaimedicine.com/conference_information.php

You can contact the association from this website. They have a list of members. I suggest you contact the association and ask for members in your area. I found a link to this website on the NOI Group site so it's possible they have provided training to this group.
There's a conference in 2009. You could encourage your practitioners to find out if this conference has new brain science as topics.

Finally, I know the doctor who is a pain management specialist and has the website How to Cope with Pain uses these methods. Personal experience with patience gives her the edge in presenting a very informative website.
http://www.howtocopewithpain.org/

I hope this is of some help. I'm sorry I can't help you further.

Friday, November 21, 2008

American Forces Defence Service News - Mirror Therapy Shows Promise in Amputee Treatment

This is a good article which shows a service person holding a mirror at right angles to his body. He is positioned so that his amputated side is behind the mirror and out of sight. He watches the mirror image of his good leg while moving the good leg. What he sees is his apparent other leg moving without pain. His brain gets the "O.K." message and the pain is eased or stopped.

Click on this post title to take you to the defense Service News article.

This same method works for chronic pain syndromes which are in a single limb. You need one good side or at least one better side. I'm using this same method at present for crps shoulder pain.

It's important to remember if pain returns after it has been relieved, then there is an underlying cause. It is most important to remember that physical therapy to regain strength, correct movement etc is very important in order to help prevent re injury and recurrence of pain.

http://www.sciam.com/article.cfm?id=phantom-limb-cure-retrain-brain

Scientific American recently posted an article by Dr Lorimer Moseley who co-wrote "Explain Pain' with David Butler of the NOI Group. http://www.noigroup.com/

Titled
Phantom Limb Cure - re-training the brain the article explains how distortions in the brain can be changed by remapping. This brain plasticity can be exploited to return the brain to normal and reduce phantom limb pain.
The principles that apply here apply also for chronic pain syndromes.

Click on the title of this post for the link to the article. Recommended.

The US connection
"Psychiatrist and psychoanalyst of the Columbia University Center for Psychoanalytic Training and Research Norman Doidge refers to this effect as 'the dark side of plasticity.'" Author of the book "The Brain That Changes Itself it is "Doidge’s conviction that neuroplasticity represents the single most important new idea in our understanding of the human brain in hundreds of years, with immense consequences for our understanding of human nature, human and therapeutic possibilities.

This link will tell you more about DR Doidge.
http://www.normandoidge.com/about/

Thursday, November 20, 2008

CBS News -Retraining the brain -Doctors Test Drug -Free Methods To Restore Lost Mental Capabilities.

Barbara posted a comment on my post "more proof that retraining the brain can relieve pain".
Barbara asked if I know of any one using these methods in the US.

To answer your question Barbara I will do a series of posts.

Today's post title links to a 2006 CBS News story, Retraining the brain -Doctors Test Drug -Free Methods To Restore Lost Mental Capabilities.

Please note that the CI therapy mentioned was designed by Dr. Edward Taub at the University of Alabama at Birmingham.

Taub says treatments that retrain the brain have been proven useful in treating strokes, brain injuries, even helping recovery from hip replacement. "There are treatments for lots and lots of conditions that are not part of mainstream treatments, but are effective," Taub says.

The article finishes,
"As science learns more about the brain's capacity to rewire itself, instead of using drugs, doctors may increasingly try teaching old brains new tricks."

Please click on this blog title to go to the CBS News report. Although not specifically about chronic pain, it shows that the US is clearly taking up the challenge and using the techniques of retraining the brain based on the knowledge of brain plasticity well worth the read.

Controlled breathing can reduce Blood Pressure. Is this just the beginning?

The Israeli company InterCure makes the RESPeRATE device that we can use at home to control high blood pressure. Health Central has an excellent article about three research trials that support the use of this device as a natural, non drug way of reducing blood pressure. The device takes you through a 15 minute cycle of breathing using music to control your in and out breath. It's a brilliant idea.

I use a similar style of breathing and have proven at home that my blood pressure will drop after just 15 minutes. I believe the research says that if you do this 3 times a week you can bring about an overall reduction in blood pressure.

I suspect that this device and this style of breathing has more to offer thasn just stabilizing blood pressure. To reduce blood pressure I believe you are activating the parasympathetic nervous system. In CRPS/RSD our sympathetic nervous systems are ramped up (just like PTSD). It makes sense to me that if 15mins on this machine can reduce blood pressure, it should also reduce pain by calming the sympathetic nervous system. I suspect this is a way of brain retraining. Whatever it is, it's very effective.

Click on the post title for the link to the article in Health Central.

Tuesday, November 18, 2008

More proof that retraining the brain can relieve pain.

How to Cope with Pain website has a brilliant article on some published research by Dr Lorimer Moseley, Nadia Zaluck and Katja Wiech titled

Tactile discrimination, but not tactile stimulation alone, reduces chronic limb pain
http://www.painjournalonline.com/article/S0304-3959(07)00631-8/abstract

I encourage you to click on this blog title to read HTCwP's article.

There is no doubt that brain retraining, which taps into the new understanding of the plasticity of the brain, can make a huge difference to people who have chronic pain. It needs to be remembered that although these techniques can ease or stop pain, pain can recur due to re injury or another event. Stopping the pain is just part of the solution. People in chronic pain have altered posture, protecting behaviours which alter posture, altered posture due to inability to use or move one part of the body properly. Once pain is lessened, the issue of getting fitter/stronger to avoid re-injuring needs addressing.

Sunday, November 16, 2008

Are you eligible for an outpatient research study in NY?

KIJIJI NYC
Free Classifides has this ad.

Location:
New York City Manhattan
Date Listed: Nov-14-08

If you are a patient with
-CRPS/RSD localized on one side of your body
-in pain despite current treatment
You may be eligible for an outpatient research study at Beth Israel Medical Center, NY.
To preliminary check whether you may be eligible for the study, call 212-844-6483.
Leave your full name and phone number, and your call will be returned in 48 hours.

I hope this study is about mirror therapy!

Wednesday, November 12, 2008

Free “Alternatives in Pain Management” teleconference

The National Pain Foundation just emailed me about Advanced Neuromodulation Systems (ANS) hosting a free “Alternatives in Pain Management” teleconference on an FDA-approved therapy for treating chronic pain called neurostimulation.

Please click on the post title to go to the National Foundation website. I recommend scrolling down and checking out other new information about chronic pain and treatments. Of note is the new deal for US Veterans and past veterans.

Down the bottom is a link which is relevant for sufferers of CRPS/RSD "Touch can relieve skin pain". "
http://www.nationalpainfoundation.org/MyTreatment/News_Month_0810.asp#Touch

Tuesday, November 11, 2008

Chronic pain - the oxygen connection

Oxygen, or lack of oxygen is involved in chronic pain pathways. Substance p is one of many neurotransmitters involved in clinical pain syndromes such as Complex Regional Pain Syndrome. Neurotransmitters transmit information across synapses. When released neurotransmitters either help or hinder electrical impulses along nerve fibers.

Substance p's relationship with oxygen deficit is well known. Oxygen deficit triggers the release of substance p. Experiments have shown that decreasing tissue oxygen concentrations increases release of substance p. The amount of substance p is relative to the level of hypoxia or put simply, the lower the amount of oxygen, the higher the amount of substance p.

It is already known that tissue hypoxia and an increase in skin lactate levels occur in Complex Regional Pain Syndrome. Oxygen free radical scavengers such as vitamin C reduce the pain of CRPS and bring about local oxygen homeostasis, inhibiting the release of substance p. Topical capsaicin (made from chillis) cream inhibits the release of substance p by increasing oxygen delivery. This, in essence, is merely a simplified explanation. Google "oxygen view of pain Majid Ali" for a more detailed explanation.

Dr Majid Ali recommends what he calls limbic breathing which he describes as a "vigorous type of breathing with a long out breath". My physiotherapist and my intergrative medicine doctor also recommend a the type of breathing where the out breath is longer or twice as long as the in breath. This type of breathing, I believe, activates the parasympathetic nervous system bringing about a sense of calm and thus helping us to better
cope with pain. Now I also realize that this style of breathing has the added benefit of encouraging increased oxygen intake.

To read more about Dr Majib and "The Oxygen View of Pain" click on this blog's title link.

Recently I've come to realize the benefit of alternate nostril breathing. Here are links to my recent post on this and a video demonstration.

http://crps-rsd-a-better-life.blogspot.com/2008/10/alternate-nostril-breathing-calms-and.html

http://crps-rsd-a-better-life.blogspot.com/2008/10/after-caution-this-is-good.html

Those of you with an interest in Hyperbaric Oxygen as a treatment for CRPS/RSD might be interested in this link to research articles.
http://www.rsdtherapy.com/research

For chronic pain sufferers it's important to remember to breathe.

Monday, November 10, 2008

CRPS/RSD - what part do anti-oxidants play?

First suggested by Sudeck in 1942, Dutch researchers' studies supported the theory that oxygen derived free radicals are possibly the mediators of mechanisms leading to some of the neurological symptoms of CRPS. They found
  • high oxygen supply with tissue hypoxia in CRPS extremities;
  • a diminished oxygen availability to the skeletal muscle tissue affected by chronic CRPS;
  • and several deficiencies in the skeletal muscles of CRPS sufferers.
Studies in Holland have centered around free radical scavengers as treatment for CRPS. There are many ongoing studies with DMSO, NAC in Holland.

Free radicals are atoms or groups of atoms with an odd number of electrons and can be formed when oxygen interacts with certain molecules. Once formed these highly reactive radicals can start a chain reaction. Their chief danger comes from the damage they can do when they react with important cellular components such as DNA, or the cell membrane. To prevent free radical damage the body has a defense system of antioxidants.

Antioxidants are molecules which can safely interact with free radicals and terminate the chain reaction before vital molecules are damaged. Although there are several enzyme systems within the body that scavenge free radicals, the principle micronutrient (vitamin) antioxidants are vitamin E, beta-carotene, and vitamin C. Additionally, selenium, a trace metal that is required for proper function of one of the body's antioxidant enzyme systems, is sometimes included in this category. The body cannot manufacture these micronutrients so they must be supplied in the diet.

Vitamin E : nuts, seeds, vegetable and fish oils, whole grains (esp. wheat germ), fortified cereals, and apricots.

Vitamin C : Ascorbic acid is a water soluble vitamin present in citrus fruits and juices, green peppers, cabbage, spinach, broccoli, kale, cantaloupe, kiwi, and strawberries.

Beta-carotene is a precursor to vitamin A (retinol) and is present in liver, egg yolk, milk, butter, spinach, carrots, squash, broccoli, yams, tomato, cantaloupe, peaches, and grains. (NOTE: Vitamin A has no antioxidant properties and can be quite toxic when taken in excess.)

Research now shows that we can substantially affect the level of anti-oxidants in our bodies by eating fresh fruits and vegetables.

Google "antioxidants for crps" to learn more.

Sunday, November 09, 2008

Research suggests possible prevention of migraine with vitamin B2

Migraine pain is believed to originate from inflammation of the blood vessels in the brain. Theories about the exact cause of inflammation range from nervous system malfunctions to an imbalance of certain chemicals in the brain.

The study using vitamin B2 (riboflavin) to prevent migraine - published in the European Journal of Neurology (2004;11:475-7)- investigated the effect of high-dose riboflavin on migraine frequency, duration, and intensity in 23 people aged 20 to 65.

Participants suffered fewer migraines and those they had were of shorter duration.


I was advised several years ago to try this. I use less than the amount suggested in the research. In my case I rarely have migraines now and those I do have are for less time and lesser intensity. I also no longer have visual field loss which was attributed to vascular spasm migraine.

If interested in this it is wise to consult with your doctor first. Self medication can be dangerous.Supplementing with high-dose vitamin B2 (riboflavin) may help prevent migraines, according to recent research.

Click on the post title for the link to the research.

Saturday, November 08, 2008

"Yes we can" do something to help ourselves when dealing every day with chronic pain.

I've chose this post as my contribution to How To Cope with Pain's November blog carnival. http://www.howtocopewithpain.org/
Click on the this post title for the direct link to the carnival and check out what others have to say.

The election is over and the speeches have been made but the message will remain all important.

I've had many encouraging responses to my recent posts about physical therapy to help pain and symptoms of complex regional pain syndrome. All have said how much they've been helped and continue with physical therapy as I do myself. The new US President Elect got it right when he said the empowering words, "yes we can". We now know that the brain changes in a positive, helpful way when we think or speak positively so I suggest we all adopt this mantra and repeat it often.
"Yes we can!"

Yes we can move a little and a little more each day. (remembering to pace)
Yes we can make immune boosting food and drink choices. (tea is a great immune booster)
Yes we can actively seek happiness. (choose a funny dvd)
We can do something to help ourselves.

If you click on "subscribe to crps/rsd a better life by email" at the top of this blog you will receive new posts in your email. Some of you have clicked "reply" to email posts and sent me a personal message. Your replies to me have been really great. I encourage some of you to post a comment so that others can share your encouraging message.

Friday, November 07, 2008

More evidence of the importance of physical therapy for CRPS/RSD.

Doctors at Great Ormond Street Hospital, London, UK have conducted a retrospective case note review of Complex Regional Pain Syndrome with Dystonia in children.

They noted that CRPS is known to occur in childhood usually involving severe limb pain, colour and temperature change, with associated loss of function.

The review concluded that children with CRPS can develop abnormal movement and this is often linked to a more severe and complex presentation requiring a very intensive rehabilitation approach.

Click on the title link to learn more.

Thursday, November 06, 2008

Review found "intensive rehabilitation approach to the management of children with CRPS is very effective in reducing pain and restoring function."

A retrospective case note review was performed for 23 patients with a diagnosis of CRPS by H Mato, S Sian, N Hasson and S Maillard at Great Ormond Street Hospital, London, UK.

An intensive programme was undertaken including twice daily physiotherapy, advice on pacing and pain management over a 2–3 week period. The main philosophy of the programme was that function be before pain was reduced.

All children improved in symptoms and function including school attendance. It was concluded that an intensive rehabilitation approach to the management of children with CRPS is very effective in reducing pain and restoring function.

Tony Tobin of RSD World News http://health.groups.yahoo.com/group/RSD-WorldNews/
has long been an advocate of physical therapy especially aqua therapy. It's good to see more studies that support this. The very strong brain message not to move and to protect needs to be overridden. I've found personally that normal movement is one of the best ways to relieve symptoms in the long run.

Wednesday, November 05, 2008

Congratulations America!

In the words of the Prime Minister of Australia, Kevin Rudd

"In electing Senator Obama, the US had lived up to Martin Luther King's famous speech in which men and woman would be judged not by the colour of their skin but by the content of their character.

Today what America has done is turn that dream into a reality.

His message of hope is not just for America's future but also for the world, a world which is now in many respects fearful for its future."

Monday, November 03, 2008

Kreativ Blogger Award

I was given this award by a Marla from http://coachmarla.blogspot.com/Marla is I believe, the first known coach od RSD/CRPS. Marla also hosts her own talk back radio program. http://www.blogtalkradio.com/winninglifethroughpain
I recommend you check out her site and listen to her broadcasts. The times and topics can be found on the blogtalk link.

Now, according to the rules of accepting the Kreativ Blogger Award I am to list six things that make me happy and pass this award on to six others.

That's easy!

1. Sharing experiences with my wonderful husband.
2. Doing things with our children, sharing a meal with love and laughter - lots of laughter.
3. Doc the dog.
4. Being with our treasured friends.
5. Watching the sunset at the beach with neighbours.
6. A good book.

I have much pleasure in passing on this award to some remarkable people.

I thank you all for the difference you've made to my life and for enriching the lives of many.
I strongly recommend you visit these sites. Take the time to look and learn.



Sunday, November 02, 2008

Preventing the development of complex regional pain syndrome could save years of possible pain and suffering.

The Reflex Sympathetic Dystrophy Association, in their patient resources, recorded an interview with Dr Scott Reuben, Director of Acute Pain Service and Professor of Anesthesiology and Pain Medicine, Tufts University School of Medicine. Professor Reuben talked about protocols for reducing the likelihoood of or worsening or spreading CRPS symptoms in patients with CRPS having surgery. He also spoke about protocols for reducing the risk of development of CRPS in patients with no history of CRPS and having surgery.

"It is thought that approximately 20% of CRPS patients who present to chronic pain clinics have a history of prior surgical procedures in the affected area with most reports of postoperative CRPS occurring after orthopedic surgery, especially after operations on the extremities."

The professor specifically mentions as well pre-emptive analgesia before dental surgery.

I received an email from Professor Reuben, in which, regarding my question about vitamin C and surgery, he says that they now incorporate Vitamin C in their protocols.

For the link to this article go to "crps/rsd related articles" to the left of this blog or click here.
http://www.rsdfoundation.org/en/PreventingRSD_Intro.html

Identifying risk factors and early intervention may prevent the development of complex regional pain syndrome.

With reference to the Swiss cohort study from my previous post, it is timely to consider what is already known about identifying risk factors and early intervention to prevent the development of complex regional pain syndrome.


The Lancet in December 1999 reported that doctors at Leyenburg Hospital, The Hague, The Netherlands in a prospective, double-blind study showed that vitamin C was associated with a lower risk of RSD after wrist fractures. They hypothesized that this beneficial effect of prophylaxis would be useful in other forms of trauma.

Pub Med reported that Researchers at Centre Hospitalier, Rue Marcellin Berthelot, 02 000 Laon, France found that the incidence of reflex sympathetic dystrophy was five time times lower in a group give vitamin C orally for 45 days from the start of the fracture. They considered that this supported previous observations and lent credibility to the value of vitamin C administration as a prophylactic measure to prevent the occurrence of reflex sympathetic dystrophy in patients who undergo surgical treatment of a displaced fracture of the distal radius.

In July 2007 the Journal of Bone & Joint Surgery reported that Drs Zollinger, Tuinebreijer, Breederveld and Kreis, Department of Surgery, Red Cross Hospital, Beverwijk, The Netherlands had conducted a randomized, controlled, multicenter dose-response study into whether vitamin C can prevent the development of Complex Regional Pain Syndrome in patients with wrist fractures.

The study concluded that Vitamin C reduces the prevalence of complex regional pain syndrome after wrist fractures. A daily dose of 500 mg for fifty days was recommended recommended.

To read more go to the link to the left of this blog under "crps/rsd related articles".

Saturday, November 01, 2008

Research suggest possiblity of new effective treatments for chronic pain patients with cutaneous tactile allodynia.

Cutaneous tactile allodynia (painful hypersensitivity to mechanical stimulation of the skin) associated with microvascular dysfunction in muscle

Laferriere, Millechamps, Xanthos, Xiao, Siau, de Mos, Sachot, Ragavendran, Huygen, bennett, Coderre. Click on the post title link for cantact information.

Molecular Pain 2008, 4:49doi:10.1186/1744-8069-4-49

Published: 28 October 2008

Abstract (provisional)

"Cutaneous tactile allodynia, or painful hypersensitivity to mechanical stimulation of the skin, is typically associated with neuropathic pain, although also present in chronic pain patients who do not have evidence of nerve injury. We examine whether deep tissue microvascular dysfunction, a feature common in chronic non-neuropathic pain, contributes to allodynia.

Our results demonstrate how microvascular dysfunction and ischemia in muscle can play a critical role in the development of cutaneous allodynia, and encourage the study of how these mechanisms contribute to chronic pain. We anticipate that focus on the pain mechanisms associated with microvascular dysfunction in muscle will provide new effective treatments for chronic pain patients with cutaneous tactile allodynia."

To read more about this click on the post title for the link.

New - Complex regional pain syndrome 1 – the Swiss cohort study

The goal of this study is a) to set up a database with patients suffering from suspected CRPS 1 in an initial stadium, b) to perform investigations on epidemiology, diagnosis, prognosis, and socioeconomics within the database and c) to develop a prognostic risk assessment tool for patients with CRPS 1 taking into account symptomatology and specific therapies.

Ideally, potential risk factors may be identified at an early stage in order to initiate an early and adequate treatment in patients with increased risk for delayed recovery.

The researchers believe that the project is timely. From a socioeconomic and epidemiological perspective many questions regarding CRPS remain unanswered. While considerable efforts have gone into basic science research dealing with pathogenesis of CRPS the clinical counterpart has not been vigorously fostered. Among the few examples we are aware of the Dutch consortium Trend which established a registry of cases with CRPS I. We think that our collaboration with this group has a significant synergistic capacity. Our partnership will contribute to a better understanding of many important aspects of CRPS and inform the future research agenda in this area. It is likely to generate considerable transfer value to the health care system not only because its results will have a direct impact on patient care but also because it allows identifying patients requiring particular attention and care. Finally, we believe that this study will guide investigators to set the research agenda in this rapidly evolving field.

To learn more please click on the title of this post for the link.

Tuesday, October 28, 2008

You're the voice - John Farnham at 2003 Aria Awards

You're the voice - you have the vote.

One of Australia's favourite sons, John Farnham's song "You're the voice" has words that ring true for the American people today. In the face of the planned assignation of a presidential candidate it is important to stand up and be counted. Here are the words. My next post is John Farnham singing his very stirring song.

We have
The chance to turn the pages over
We can write what we want to write
We gotta make ends meet, before we get much older

We're all someone's daughter
We're all someone's son
How long can we look at each other
Down the barrel of a gun?

Chorus:
You're the voice, try and understand it
Make a noise and make it clear
Oh-o-o-o, whoa-o-o-o!
We're not gonna sit in silence
We're not gonna live with fear
Oh-o-o-o, whoa-o-o-o!

This time
We know we all can stand together
With the power to be powerful
Believing, we can make it better

Oooooooh,
We're all someone's daughter
We're all someone's son
How long can we look at each other
Down the barrel of a gun?...

You're the voice, try and understand it
Make a noise and make it clear
Oh-o-o-o, whoa-o-o-o!
We're not gonna sit in silence
We're not gonna live with fear
Oh-o-o-o, whoa-o-o-o!

Sunday, October 26, 2008

Power to the people - in this difficult time, the peoples of the United States of America have the future in their hands.

Very soon the peoples of America will be charged with the responsibility of choosing the future direction of a mighty country. I encourage you to make your vote count, to seek the facts for yourselves. Knowledge is power. Let not creed, nor background, nor charm, nor race dictate your choice. Rather determine whether your candidate is honourable, ethical, intelligent, decisive and of good stamina.

I googled for information on the policies of the two parties.

Here is Senator Obama's site. If you click on "Blue print for change - download document" you'll find his party's stance on some important issues.
http://209.85.175.104/search?q=cache:8SRWKuHPPg4J:www.barackobama.com/issues/+barak+obama+policies&hl=en&ct=clnk&cd=1&gl=au

Here's an overview from the document.

"AT A GLANCE
• Enact an Emergency Economic Plan to Inject Immediate Relief into the Economy
• Provide Meaningful, Permanent Tax Relief for Middle Class Families
• Protect Homeownership
• Make Strategic Investments in America to Create Millions of New Jobs
• Improve Regulatory Oversight of Financial Markets
• Fight for Fair Trade Agreements
• Crack Down on Predatory Credit Card and Lending Practices
• Support Working Families and Strengthen Labor Laws"

Senator McCain's website lists Issues. If you click on further information and then continue to click you will get an idea of some strategies suggested to address the particular issue.
http://www.johnmccain.com/Informing/Issues/
I wasn't able to find a summary of proposed policies or I'd list them here.

I am posting this because the future direction America takes affects us all as we've so recently seen. I beseech you to choose wisely and after the decision is made, take some time and care for yourselves.

Recent evidence has shown stress affects pain threshold.

Research at Department of Psychology and Human Development, Vanderbilt University, Peabody 512, 230 Appleton Place, Nashville, TN 37203, USA say " research demonstrates the first evidence of the occurrence of stress-induced hyperalgesia in a pediatric pain population."
http://www.ncbi.nlm.nih.gov/pubmed/17716818

American Pain Society reported a study by Roger Allen and Chad McCann of
University of Puget Sound, Tacoma, WA which hypothesized that "increased pain activity appearing ten-days after stressful events may be related to the psychogenic release and activity of the stress-related hormone thyroxine, in patients with CRPS".
http://aps.confex.com/aps/2008/webprogram/Paper8452.html

A web based epidemiological survey of complex regional pain syndrome shows 82% of participants noticed that emotional stress increased pain.
http://www.rsds.org/3/pdf/Modified%20ASA%20poster-RSDSA.pdf

The European Journal of Neurology reported the results of University of South Australia study on induced stress on experimental pain in chronic tension type headaches. Results support the hypothesis "that stress may contribute to CTH through hyperalgesic effects on already sensitized pain pathways in CTH sufferers."
http://www3.interscience.wiley.com/journal/119416344/abstract?CRETRY=1&SRETRY=0

I know that stress ramps up symptoms and that one of the best ways of calming symptoms is to decrease stress. However, in the real world controlling stress can be difficult. Right now, in counties all over the world there is a huge concern over the global financial crises.

Very soon the American people go to the polls. This is a stressful time. The research seems to indicate that we cope with the stress and pay for it some time later. In the days and weeks after the decision making take time to look after yourselves, seek happiness, ways to de-stress and take care of yourselves.
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