The Ins And Outs Of Chronic Myofascial Pain

Understanding chronic myofascial pain relies on our understanding of the illusive myofascial trigger point (TrP).

WHAT IS A TRIGGER POINT?

Trigger points (TrPs) are those knotted up pieces of muscle fiber that feel like a frozen pea in a taut band of average sized muscle. Anyone can usually feel a TrP unless it/they: 

• are behind bone,
• are in muscles that are under other muscle,
• the muscle is too tight to locate the TrP.

If the band of muscle affected is too tight, it may be difficult to isolate the TrP causing pain. A specially trained physician or therapist may only be able to identify the TrP/s by the dysfunction and radiation of symptoms they create. A specific pattern is associated with the location of each specific TrP.

THE GREAT IMITATOR

Myofascial trigger points are the root cause of chronic myofascial pain, also called myofascial pain syndrome or MPS. The cranky knots can cause symptoms that mimic many things. They are not only responsible for pain, they can also cause muscle and joint dysfunction, and they do not have to be big to be mighty. They can cause numbness and tingling, burning and other nerve symptoms when a TrP is entrapping a nerve. These symptoms can be local or radiate in a specific pattern that remains consistent among all patients. Circulation and temperature changes can occur if TrPs are located next to a blood vessel and swelling can develop if the TrP is located next to a blood or lymph vessel.

Trigger points can develop in anybody who experiences muscle strain or injury. Generally, these isolated events can be successfully treated with lasting results. However, that is not the case in myofascial pain syndrome. In MPS trigger points resist treatment, develop in other parts of the body, and persist for a prolonged period.  

You can read more about trigger points, how they are classified and additional resources in “What Is a Trigger Point?”, which is also provided in the header tab of this blog.

WHAT IS CHRONIC MYOFASCIAL PAIN?

“Chronic myofascial pain is a disease that affects the chemicals that cross between nerve endings and muscles. It is literally, a disease at the neuromuscular junction—nerve to muscle... [it] is a chronic disorder in which myofascial trigger points (TrPs) cause sensory, motor, and autonomic symptoms. This condition may develop in muscles that are overstressed, overused, or injured. Different from isolated incidental occurrences of trigger points that can happen to normal individuals, CMP develops when TrPs are apparent in several quadrants of the body and have become chronic. The trigger points may be active, latent, or secondary.”

Excerpt from Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-Body Connection by Celeste Cooper, RN and Jeffrey Miller PhD

Mayo Clinic (accessed February, 2020)  suggests sleep problems and development of fibromyalgia are complications of untreated myofascial pain syndrome. 

Myofascial pain syndrome coexists with many painful conditions. These include ─ but are not limited to ─ fibromyalgia and chronic fatigue/myalgic encephalomyelitis, migraine, spinal degeneration, teeth grinding, restless leg syndrome, TMJ, interstitial cystitis, irritable bladder, arthritic joints, congenital musculoskeletal malformation, repetitive motion, a static position, and more. Chronic myofascial pain can develop from the effect of diseases, such as polio, and can result from injury or post surgical scaring, too.

Hands on myotherapies, ultrasound guided trigger point injections, self-treatment of TrPs, controlling perpetuating factors are things we can do. It is helpful to know I have some control over the beast that can create so much agony.

Additional Reading:

Do Tight Muscles Cause You Pain? What You Should Know About Chronic Myofascial Pain

What You Should Know About Myofascial Pain for ProHealth
The Lessons Of Myofascial Pain Syndrome And Fibromyalgia for ProHealth

In healing,

Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!

http://www.CelesteCooper.com

~ • ~ • ~ • ~ • ~ • ~

Learn more about Celeste’s books here. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others. 

Happy With Hemp: Fibromyalgia And Chronic Pain

This post contains affiliate links. See my 

FTC disclosure page.

https://HappyFlowerCompany.com

A couple of years ago as a freelance writer, I wrote several articles about cannabis and cannabinoids for Health Central. I gleaned a great deal of information in my writing assignments. In this slideshow, I cover things like the cannabis plant: is it hemp, CBD, or marijuana? Does it matter?

It was from those assignments that I decided to try CBD for my pain. However, the lack of reliability disappointed me. I purchased many different tinctures and topical products. However, there was no certainty about my purchase. Was there really a “broad spectrum” of cannabinoids? My pocketbook was not appreciating the cost of my experiments.

So, when the folks at Happy Flower Company asked me to try hemp, I was curious enough to say yes, and I am glad I did. Finally, I would know the presence of certain cannabinoids and their concentration. I could read the lab reports, which you can find on their website. I could give it a fair analysis independent of the guessing game of other products.

MY EXPERIENCE

There is no cure for my pain generating conditions and I am not making any claims that hemp is a miracle plant; however, I can say my joint pain is better, and my fibromyalgia tenderness has greatly improved.

Additionally:

• I can use it and still write, because there aren’t any psychoactive effects.
• The plant has a plethora of cannabinoids and terpenes that work together to provide the best effect.
• I know the concentration because Happy Flower Company provides the lab reports.
• It is grown organically.
• It’s not addictive.
• It’s affordable.

You can learn more about hemp, here.

WHAT THE HECK IS A TERPENE?

When I first heard this term, I was clueless. Here is what I have learned.

Terpenes are chemicals found in the cannabis sativa species, which includes both hemp and marijuana plants, other plants and foods. They give certain plants, vegetables, and fruits their identifiable aroma, taste, and color. Terpenes often influence the name of cannabis species plants.

You might find this interesting, like I did. In 2015, the European Journal of Pharmacology published the study, “Evaluation of the anti-inflammatory, anti-catabolic and pro-anabolic effects of E-caryophyllene, myrcene and limonene in a cell model of osteoarthritis.” Authors, Rufino, A.T., et al. concluded in particular, myrcene has a significant anti-inflammatory effect, fights the destructive effects on the cartilage matrix and believe it has the ability to halt or slow down cartilage destruction and osteoarthritis.

A more recent study, August 2019, by Jansen, C., et al., Myrcene and terpene regulation of TRPV1, suggests formulations containing mycrene have the potential to produce an analgesic effect.

GETTING AQUAINTED WITH HEMP

Having fibromyalgia, I am super sensitive to many things. Therefore, I found the abundance of terpenes in hemp to be overly strong when smoked. I solved that issue by investing in a leaf vaporizer, problem solved and I feel vaporizing the leaf is healthier.

WHAT THE FUTURE HOLDS

My plans are to keep vaping hemp leaf twice a day, because that works best for me. I am eager to try the isolate, because I can reconstitute it into a tincture or topical with a concentration that works best for me.

AND

I have decided to be an advocate for Happy Flower Company, so I can offer you a 15% discount when you use my code:

PainedInkSlayer

*If you are on medications please discuss hemp (cannabinoids) with your doctor or pharmacist. Like medications, including those we buy over the counter, it is a biochemical.   

In healing,

Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!

http://www.CelesteCooper.com

~ • ~ • ~ • ~ • ~ • ~

Learn more about Celeste’s books here. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others. 

Winter Speech: Dry Mouth And Fibromyalgia

Photo from BBWS-Winter

The brisk arid climate of winter affects many of us. It happens to be an aggravating factor of what I call my dry fibro body. Our speech is affected, our tongue sticks to the roof of our mouth, and we crave water as if we just walked through the Mohave Desert.

With permission from ProHealth I am reposting “Dry Mouth And Fibromyalgia: How To Overcome It”, which was first published at ProHealth.com February 6, 2019 and updated on September 17, 2019.

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Despite it being a common complaint among fibromyalgia patients, it’s not something that’s often discussed in articles or online groups and forums, but it’s frustrating, nonetheless.

In this article, I want to review the consequences of chronic dry mouth, in particular. We will consider possible causes, its relationship to fibromyalgia, the effects on our gastrointestinal tract, and ways to manage it.

What Is Dry Mouth?

Chronic dry mouth, xerostomia (pronounced zero-stO-mEa), is the result of insufficient saliva secretion. This is important because saliva washes away food debris, buffers digestive acids that can cause tooth decay, reduces the formation of plaque, and begins the digestive process.

In 2002, one study reported that salivary gland dysfunction could be exacerbated by several factors, including medications, autoimmune diseases, cancer of the head or neck, neurological conditions, hormonal fluctuations and more. Additionally, a 2018 study  provides insights into the mechanisms by which saliva acts as protector and how it relates to taste, chewing, formation of food blockages in the esophagus, enzymatic digestion and swallowing.

Those of us who live with fibromyalgia symptoms should be on the lookout for conditions that can aggravate chronic dry mouth.

Causes Of Dry Mouth

Let’s take a more in-depth look at the myriad of things can act as causes of dry mouth, such as:

• Mouth breathing
• Poor diet
• Dehydration
• Chemotherapy
• Radiation
• Central and peripheral nerve damage that affects salivary glands
• Small fiber neuropathy
• Removal of salivary glands (such as seen in oral cancer)
• Medication side effects
• Medical conditions like Sjögren’s, thyroid disease, diabetes, and Lupus)

Furthermore, chronic dry mouth is also one symptom of Sicca syndrome. Sicca is collection of symptoms characterized by unusually dry eyes, mouth, throat, nose, and other mucous membranes. Sicca symptoms are commonly associated with the autoimmune disease called Sjögren’s. Some people interchange the two, and others see Sicca syndrome and Sjögren’s Syndrome quite differently. My own rheumatologist sees Sicca as Sjögren’s without the presence of tissue specific antibodies.

Herein lays the connection between dry mouth and fibromyalgia. In another 2018 study, researchers concluded about 1/3 of fibromyalgia patients tested positive for Sjögren’s-related biomarkers. Plus, the majority of the testing population had the presence of other autoimmune antibodies, lending further credence to the idea that autoimmunity and fibromyalgia are connected.

The Consequences Of Dry Mouth

Chronically thick and stringy saliva, a horse or dry throat, a tongue that is grooved or coated white, or sticky surfaces in the mouth suggests the presence of chronic dry mouth. This can contribute to:

• Difficulty speaking
• Difficulty chewing, swallowing, and tasting
• Insufficient digestive enzyme production
• Increased risk of bacterial and fungal infections (which can travel out of the mouth into the body’s circulation)
• Burning mouth syndrome
• Bad breath
• Mouth sores
• Dental cavities
• Gum disease
• Malabsorption of nutrients
• Gastrointestinal dysfunction

If left untreated or unmanaged, complications related to dry mouth can affect our overall health.

Things We Can Do To Help Chronic Dry Mouth

One of the first things I learned in nursing school was the importance of oral care. Keeping a patient’s mouth moist with glycerine swabs and treating their lips with oral moisturizers is a significant nursing intervention to maintain oral health as well as the health of the body. Other things we can do include:

• Address lifestyle issues, such as stress, diet, tobacco use.
• Consider contributing factors, such as sleep apnea or other airway obstructions (i.e. deviated septum), teeth grinding, TMJ, etc.
• Practice good oral hygiene as recommended by the American Dental Association. Brush teeth twice a day with fluoride toothpaste, clean between teeth daily, limit sugary beverages and snacks, see a dentist regularly.
• Avoid overuse of caffeine, carbonated beverages, and alcohol, which are dehydrating.
• Avoid sugar.
• Sip on water frequently.
• Rinse mouth frequently.
• Don’t use mouthwash that contains alcohol.
• Use oral lubricants and saliva substitutes.
• Suck on sugar-free hard candy or chew sugar-free gum to stimulate saliva production. (Discuss these options with your dentist.)
• Use a humidifier.
• Talk to your dentist about a mouthwash that increases saliva.
• Talk with your doctor or pharmacist about medication side effects. (i.e., antihistamines or other medication used in fibromyalgia treatments).
• Talk with your doctor about prescription medications that can increase saliva production.

Chronic dry mouth is complicated; it’s far more than having periodic cotton mouth.  And, while we may not always know what causes it, there are things we can do to minimize the effects, and in the process, have an effect on our overall health.

Applbaum, E., and Lichtbroun, A. (2019). Novel Sjögren's autoantibodies found in fibromyalgia patients with sicca and/or xerostomia. Autoimmunity Reviews, 18(2):199-202. https://www.ncbi.nlm.nih.gov/pubmed/30572137

Granot, M. & Nagler, R.M. (2005). Association between regional idiopathic neuropathy and salivary involvement as the possible mechanism for oral sensory complaints. Journal of Pain, 6(9):581-7.

https://www.ncbi.nlm.nih.gov/pubmed/16139777

Mavragani, C.P., Skopouli F.N.,and  Moutsopoulos, H.M. (2009). Increased prevalence of antibodies to thyroid peroxidase in dry eyes and mouth syndrome or sicca asthenia polyalgia syndrome. Journal of Rheumatology, 36(8):1626-30. https://www.ncbi.nlm.nih.gov/pubmed/19605678

Pedersen, A.M. ,  Bardow  A.,  Beier Jensen, S.,  Nauntofte, B. (2002). Saliva and gastrointestinal functions of taste, mastication, swallowing and digestion. Oral Diseases, 8(3):117-29.

https://onlinelibrary.wiley.com/doi/full/10.1034/j.1601-0825.2002.02851.x  

Pedersen, A., Sørensen, C.E., Proctor, G.B., Carpenter, G.H. (2018). Salivary functions in mastication, taste and textural perception, swallowing and initial digestion. Oral Diseases, (8):1399-1416. doi: 10.1111/odi.12867. Epub 2018 Jun 7.

https://www.ncbi.nlm.nih.gov/pubmed/29645367

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You can read more of the articles I have written for ProHealth, here. Take a look around. ProHealth is dedicated to providing helpful information on fibromyalgia, and more.

In healing,

Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!

http://www.CelesteCooper.com

~ • ~ • ~ • ~ • ~ • ~

Learn more about Celeste’s books here. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others. 

When Your Frozen Muscles Need Help: Myotherapies for Managing Myofascial Pain

When the myofascia isn’t free to move, other muscle movement is also impaired. This leads to joint dysfunction and chronic PAIN. This pain is universal with distinctive patterns that remain consistent in all people. In some cases, restrictions can be so extensive joints become frozen, meaning joint motion is severely restricted. The goal of all myofascial therapies is to restore normal muscle function. Following are helpful hands-on therapies that work to release restrictions and help our body achieve full normal range of motion.

MYOFASCIAL TRIGGER POINT THERAPY

Myofascial pain syndrome  (MPS) is a constant pain source when trigger points (TrPs) are left untreated.

Trigger point therapy done by a specially trained therapist releases the knotted muscle fiber (TrP) using a compression technique. The therapist will know to look for other TrPs, which are sometimes well away from the one that is causing you so much pain. They know there is a consistent pattern related to the specific location of a TrP in that taut band of muscle. Release TrPs returns muscle to normal function.  That said, the work isn’t all up to the therapist. A good therapist will help you learn the importance of knowing what things are perpetuating your pain. A big one for me is sitting here at this desk staring at my computer screen, or riding in a car for too long.

Chronic myofascial pain from MPS is often accompanied by other disorders, such as fibromyalgia, migraine, spinal degeneration, irritable bladder, arthritis, joint hypermobility, and more. Dr. Karl Hurst-Wicker explains “Fibromyalgia Centralization and Peripheral Myofascial Pain” in an interview I did for Health Central.

Created by Celeste Cooper, The Pained Ink Slayer(c)

Chronic myofascial pain can be the primary source of pain or it can perpetuate pain in other disorders, injuries, or anatomical deformities. The good news is that myofascial pain syndrome is treatable. The goal is to release the trigger point/s so that the muscle tissue returns to its normal functioning position.

MYOFASCIAL RELEASE (MFR)

As so many of us who write about myofascial pain explain, the myofascia is like chicken skin. It’s attached to the muscle, but still moves freely. If you have ever cut up a chicken, you can visualize what that is. Each muscle is covered by myofascia (muscle covering) that draws together on each end to form a tendon. Tendons attach muscle to bone so our joints can function. The goal of myofascial release is to free up myofascial restrictions so our body can function properly.

Developed by physical therapist John F. Barnes, myofascial release is a manual therapy performed by a skilled therapist with the goal of improving movement and promoting wellness.

My personal experience with MFR was enlightening to the physical therapy student following my therapist. During a session, my back starting twitching like a flickering light bulb, the student became tongue-tied. She stated she had not witnessed such a phenomenon. The physical therapist was glad her student was able to see firsthand what restricted myofascia can do and how it contributes to chronic pain.

It’s important to always check the credentials of anyone doing body work. They must have a firm understanding of anatomy of physiology. Here is a directory of myofascial release therapists recommended by John Barnes. http://mfrtherapists.com/

NEUROMUSCULAR THERAPY AND REPROGRAMMING (NMR)

The goal of Neuromuscular Therapy and Reprogramming (NMR), founded by body-worker Jocelyn Olivier, is to balance the central nervous system and the musculoskeletal system by engaging the motor center of the brain.  Therapists specifically trained in NMR treat soft-tissue restrictions, which relaxes muscles, rebuilds strength, improves flexibility, restores venous and lymph flow, and relieves the underlying cause of pain. The therapist will assess blood flow, myofascial TrPs, nerve compression, problems with gait, posture and body alignment, and perpetuating factors.

Other types of bodywork include spray and stretch, Bonnie Prudden Myotherapy, strain counter-strain technique, and deep tissue bodywork, such as Rolfing and Active Release Technique (ART). I caution those with fibromyalgia on deep tissue work. It can be too painful for some. I am lucky to have a physical therapist that does ART. Some chiropractors also use this technique, but the most important thing is to have a working relationship with your therapist and keep the lines of communication open.  

WHAT WE CAN DO

Any myofascial therapy requires us to contribute for the best outcome. We can identify perpetuating factors and practice preventive strategies like stretching and strengthening to maintain muscle health, stamina, and general overall wellness. (Caution: strengthening should be done once the muscle is functioning properly again.) We can be persistent in finding the right therapy or the right therapist. Both are equally important. Maybe you find a therapy you want to try, insurance covers it and all seems well. However, I offer a word of prudence, the type of therapy doesn’t matter if you don’t have a knowledgeable therapist who is willing to work with you and teach you why certain things are important.

A guidebook that focuses on the work of doctors Travell and Simons will help you learn methods of self-treatment and a good therapist will suggest that you do just that. There is information to suggest that when home therapy is encouraged, we do better.

IN CLOSING

Always talk with your doctor for medical clearance. Sports medicine physicians and physical therapists are often a good resource for those of us living with chronic myofascial pain.

Additional Reading:

Physical Therapy for Chronic Pain

In healing,

Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!

http://www.CelesteCooper.com

~ • ~ • ~ • ~ • ~ • ~

Learn more about Celeste’s books here. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others. 

6 Fibro Musings: A Look Back As We Look Forward

As the New Year begins, I give thanks for the wonderful work of advocates and fellow bloggers who have shared valuable information that helps me in my own journey.

Following are some of the top trending blogs here on The Pained Ink Slayer. I hope this look back will help you find something you can use in the upcoming year.

The Pained Ink Slayer Series: 4 Ways to Power Up Your Positivism

…what four things can we do to spiff up our attitude and claim our stake in the power of positivity?

How Aware Are We? Fibromyalgia And Aggravating Conditions

 “What am I doing, or not doing, that adds to my misery?” “How can I identify and manage perpetuating or aggravating factors?”…

How Can A Pea Cause So Much Pain? Defining Myofascial Trigger Points

A myofascial trigger point (MTrP) is a “self-sustaining” hyper-irritable area of muscle fiber in a taut band of muscle that is felt as a nodule or bump… Note: Trigger points are not tender points, however, chronic myofascial pain can and often does co-occur with fibromyalgia.

5 Things You Should Know About Dysautonomia If You Have Fibromyalgia

There is sufficient evidence to correlate dysautonomia and fibromyalgia.

*5 Things You Should Know About Dysautonomia If You Have Fibromyalgia, originally appeared on ProHealth.

Baby It IS Cold Outside: What You Should Know About Raynaud’s And Fibromyalgia

Research tells us symptoms of Raynaud’s phenomenon occur in fibromyalgia patients.

PublicDomainPictures.net

Heroes As Helpmates Dealing With Fibromyalgia Or Other Chronic Pain And Illness

…heroes are people I admire for their tenacity and their ability to show gratitude despite facing significant obstacles…

Note: Archived blogs are in the right column of this page, links to access Celeste’s freelance articles are in the header tab Celeste’s Publications, and this particular blog will be in the header tab Fibro Musings.

Happy New Year!

Previous Fibro Musings

In healing,

Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!

http://www.CelesteCooper.com

~ • ~ • ~ • ~ • ~ • ~

Learn more about Celeste’s books here. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others. 

Baby It IS Cold Outside: What You Should Know About Raynaud’s And Fibromyalgia

When Color Hurts

It is getting cold outside. Sure, it isn’t frigid everywhere, but it is seasonably colder this time of the year. Those of us with fibromyalgia who also experience Raynaud’s symptoms understand we are at a higher risk of an attack. What is the connection, are there other triggers, and is there anything we can do?

Research tells us symptoms of Raynaud’s phenomenon occur in fibromyalgia patients. However, there are differences in some observations between the primary Raynaud’s group (those without a co-occurring disorder that would explain the phenomenon) and the secondary Raynaud’s group (which in this case includes subjects with fibromyalgia).  I am not sure where those of us diagnosed with primary Raynaud’s decades before being diagnosed with fibromyalgia belong on this spectrum, but I am also not sure it matters. So, let’s look more at what it is and how we can manage the symptoms.

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“When [Raynaud’s] occurs by itself, it is called Raynaud’s disease, or primary Raynaud’s phenomenon. When it occurs along with other diseases, such as scleroderma, rheumatoid arthritis, systemic lupus erythematosus, polymyositis, dermatomyositis, Sjogren’s syndrome, or mixed connective tissue disease, it is called secondary Raynaud’s phenomenon.”Cooper and Miller, 2010, pg. 106-107

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Symptoms

A defining characteristic of Raynaud's is that it mostly affects the fingers, nose and toes, though it can affect other areas of the body like the ears and nipples. The symptoms of Raynaud’s most commonly occur when exposed to cold, though it can also be triggered by anxiety or stress.

During an attack skin color often changes from pale to blue, and turns red during re-warming, though fibromyalgia patients are more likely to exhibit only pallor.  If you have it, you know we also experience extreme numbness during the acute phase. This puts us at a greater risk for frost bite and reminds us why we should pay close attention. I carry gloves with me year round because so many places keep it cold, particularly grocery stores where we are also handling cold meat and frozen foods.

Picture is Courtesy of http://clipart-library.com/

It is suspected that the nerves to the blood vessels cause them to spasm. These vasospasms affect our microcirculation and deprive our small blood vessels (capillaries) of blood and oxygen, hence pale or blue color changes. As blood vessels relax during re-warming, redness of the skin occurs. This phase is frequently associated with extreme incapacitating pain, stinging and/or burning. If you have Raynaud’s, you know there is no mistaking the symptoms.

*Symptoms of Raynaud’s should not be confused with feeling cold, which is often associated with fibromyalgia.  Cold intolerance could be due to an upset in our neuro-endocrine system, and could be attributed to autonomic effects of fibromyalgia or hypothyroidism.

Your doctor may order a cold stimulation test, a nail fold capillaroscopy, or vascular ultrasound to make the diagnosis and determine if Raynaud’s is primary or secondary.

Treatment goals:

·        Re-warm slowly.

·        Protect fingers, toes and nose from cold exposure to prevent frostbite and skin ulcers.

·        Avoid emotional stress.

·        Avoid alcohol, particularly when you know you will be exposed to cold.

·        Don’t smoke.

·        Avoid use of tools that vibrate the hands.

·        Myofascial trigger point (MTrP) nerve entrapment can worsen symptoms of Raynaud’s, so check MTrPs associated with the referral patterns to the affected area. Check out this great article at NielAsher.com Continuing Professional Education.

·        Vasodilator type medications may be indicated in severe cases.

·        There are certain medications to avoid if you have Raynaud’s, so be sure to consult with your physician or pharmacist.

Report any unusual symptoms or skin breakdown to your physician immediately.

Additional Reading:

Critical Steps for Avoiding Raynaud’s Complications

In healing,

Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!

http://www.CelesteCooper.com

~ • ~ • ~ • ~ • ~ • ~

Learn more about Celeste’s books here. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.