Stressed? Techniques for Managing Negative Stress

Stressed? Techniques for Managing Negative Stress

One of the constants in our lives is stress. Just reading that may induce stress for you but the reality is that not all stress is negative. Stress is, most simply, your body and minds way of reacting to situations in life; both the good and the not so good situations. Stress is the elation you feel when someone you’ve been missing is suddenly right in front of you. It is also the frustration that you experience when you see a parking ticket on your windshield. The term “stress” isn’t necessarily negative but we associate it that way so much that it has become synonymous with uncomfortable feelings. Which is, for many us, the main type of stress that we experience. So, let’s take a dive into the negative stress that affect us all and what we can do about it in our lives.

The First Step

The first thing to do is to identify what exactly is causing you stress. You can’t work on a problem that you can’t put your finger on.

  • Step One: Identify the cause or causes of your stress. Look at the overall view here and keep it simple. Is it work, personal life, finances specifically, health- related issues or a combination. Any problem seem insurmountable when it’s as big as a mountain. Break it down into basic, single points to focus on. Even if you have multiple areas of stress, just the act of putting it down on paper (or a spreadsheet if that’s your comfort zone) and sorting it with a plan of action can help you see that it IS manageable; even when it feels like it is too much.
  • Step Two: Identify what you can realistically do to alleviate or eliminate the stressors. Go down your list and do a quick run and tick off of what can you have an impact on and what you can’t. This is the first step here to see what you need to work on to eliminate versus what you need to slot into the category of “to be managed” if you personally cannot affect change on the stressor. Some stressors will resolve themselves with time and there is nothing that can be done but to manage how it affects you until the situation is over. Other times, the situation will not change until YOU change it. Those differences aren’t always apparent when you are in the middle of the stress.

The Next Steps

Now that you know what is causing you negative stress and which stressors are within your range of being able to make an impact or not. Let’s look at strategies to help.

  • Eliminate or alleviate what you can: Be realistic and plot out what you need to do to make things better with the stress in your life. If you can make a difference, then make the changes needed. You will thank yourself in the end. It may not be easy but it will be worth it. Since this area is specific to each person, only you can be the one to write this list. Be honest about your needs and wants and make your plan realistic to what you can offer for energy, focus and time. Even small changes and movement in the right direction will make a huge difference in how you feel about stress right now.
  • Learn how to manage the effects of stressors that you can’t do anything about: The fact is that there are going to be things that you can’t change in your life. In these instances, you will need to look at stress management techniques that will work for you, that you can put into action.

Stress Management Techniques

Negative stress can wreak havoc on our bodies and minds. Most of us are well aware of how we feel when stressed. Racing heart, elevated blood pressure, upset stomach, nervousness, anxiety, and anger are common complaints. It can affect your entire body in ways that make day to day life difficult and uncomfortable to deal with. What works to help manage the impact of stress for each person differs greatly but some options to start the ball rolling for what to try include:

  • Taking care of your body: Eat well, and drink water; exercise in a way that you find enjoyable and feels good for your body; try to get restful sleep; explore different physical relaxation techniques such as yoga, meditation or focused breathing techniques.
  • Relax your mind and emotions with ways that work for you: Journaling or writing; listening to music; use guided imagery podcasts or similar media to help you if you find meditation a challenge; talk it out – find a friend or a therapist that can help you get some of the internal stress out in that way.

We tend to shy away from stress because it is already causing concerns in our lives and we certainly don’t want to put more attention to it, but that’s just what is needed for most of us.

With some focus and research into what is causing negative stress in your life, you can make a difference.

Check out this other great resource for more detailed information and suggestions on how to manage your stress.

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Could Your Foot Pain Be Plantar Fasciitis?

Plantar fasciitis is a painful condition located along the bottom of the foot, predominantly in the arch area. It is caused by overuse of the arch tendon (plantar fascia) of the foot; and if you’ve ever suffered from Plantar Fasciitis, you know that this can be one of the most irritating and hard to treat injuries there is.

The most common causes of plantar fasciitis are overly tight or inflexible calf muscles and/or surrounding and supporting tendons which leads to persistent pronation of the foot. This pronation can produce over-stretching of the arch tendon, and can lead to inflammation and thickening of the tendon.

The Plantar Fascia is a band of tissue that runs from your heel down through most of the length of your foot. It could be considered to be a “shock absorber” for your arch. This tissue is also known as the arch tendon. When this tissue becomes inflamed, the result is Plantar Fasciitis, a condition that can result in moderate to severe pain in your heel and foot.

Plantar Fasciitis, over time, can also cause a heel spur. If untreated, the condition can become degenerative, causing further pain, symptoms and long-term treatment challenges.

Not surprisingly,  runners, golfers and tennis players who spend long hours on their feet are some of the most common victims of Plantar Fasciitis.  Additionally, those over 40 are more susceptible, as is anyone who is predisposed to the condition. People with tight calves are thought to be more likely to develop the condition, as is anyone who spends time on their feet without proper footwear.

Temporary relief from Plantar Fasciitis can often be found through stretching localized massage, or anti-inflammatory medications. This relief is typically short-lived, however, as the condition will usually persist until it is properly treated and the underlying cause is identified and addressed.

Permanent relief from Plantar Fasciitis will usually come from a combination of the following approaches:

– Improved footwear for the activity you’re engaging in

– Orthotics, if determined to be necessary to proper foot alignment and support.

–  Specific Stretching for the foot and calf muscles

– Physiotherapy; IMS is often used in this area.

– Massage

– Laser Therapy to treat the inflamed area

– Athletic tape to support the arch tendon

– Shockwave Therapy to treat the inflamed area

You should seek treatment if you suspect that you may have this conditions as it can become more severe if left unattended.

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Don’t Just “Fall” Back Into It

Summer is coming to a close and the feel in the air is of back to routine and a sense of normalcy to our schedules.

As we head back to school, work schedules and a more structured day, now is the time to take stock and see what’s working and what isn’t.

The urge to just “Fall” back into the same old routines is tempting and easy but not always the best course of action. Take some time to really look at how your days, weeks and months are structured. Do some days and timetable make you pull your hair out, hanging on for the reprieve of a weekend? Do you dread certain days or times when you know the stress and workload will wear you down? Take a closer look at the good times to really see what it is you value in those times.

Sometimes a few adjustments, some forethought, planning and re-structuring is all that’s needed to make a hectic schedule run more smoothly and reduce stress for yourself and those around you.

As we head back to it all, don’t just settle for routine, you are in control of how it all plays out – make it the way you want it!

“Time is a finite resource and we all place infinite demands on it. I view time as an opportunity, as a chance to make choices about how I spend that resource – because it is our choice. And that’s something people often forget.

Maggie Wilderotter”

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Summer Sun Protection 101: Choosing The Right SPF

Summer Sun Protection: Choosing The Right Sunscreen

It’s summer time and with the longer days and much-anticipated sunshine comes the need for protecting your skin from sun damage. One of the easiest to do that is by using a sunscreen with the right amount of SPF, and the options seem endless. Here’s how to choose the right sun protection for your skin.

SPF: What It Means and Why It Matters

We hear the acronym ‘SPF’ a lot at this time of year, but do you really understand what it means and how the SPF rating of your sun protection can determine how well your skin is protected from sun damage?

SPF stands for Sun Protection Factor and is a relative measure of how a product will protect you from UV radiation (Predominantly UVB rays unless otherwise specified on the label). Products generally range form low SPF of 15 to much higher rating of up to 100 SPF.

While a Higher Spf Offers an Increase in Sun Protection, It’s Not Always a Much as You Might Think

  • SPF 15 will block approximately 93% of UVB rays.
  • SPF 30 will block approximately 97% of UVB rays
  • SPF 50 will block approximately 98% of UVB rays
  • SPF 100 will block approximately 99% of UVB rays

Broad Spectrum Sun Protection is Best

For UVA and UVB protection, look for a suncreen that states it is broad spectrum. Mineral sunblocks that contain a high amount of zinc oxide, when applied correctly, offer excellent broad spectrum sun protection. Elta MD is just one example of a reputable brand that carries mineral-based, broad spectrum sunblocks.

If you’ve avoided mineral-based sunblocks out of fear that they will leave your skin looking ashy or covered in white streats, CBC offers this list of 10 mineral sunblocks that are suitable for dark complexions.

If you spend a lot of time in the water, many mineral-based sunscreens are reef-safe as well. The key is to always read the labels so you know what you’re getting when it comes to your sun protection!

Using Your Sunscreen Properly

How you use sunscreen increases the effectiveness of it as well. Most people don’t use enough, or re-apply as often as they should to be protected.

  • An adult sized person should be using 2 tablespoons (or more) of sunscreen to cover all exposed skin.
  • To be effective, it should be reapplied every two hours, or more if you are swimming or sweating excessively.
  • Remember to use sunscreen even on cloudy days; UV rays can pass through clouds.
  • Check the expiry date! Some of the compounds in sunscreen lose their efficacy over time – be sure to check that it is still within the posted expiry date on the label.
  • Protect your sunscreen from the sun and heat. Extreme temperatures can also break down the compounds in the sunscreen so be sure to tuck the bottle away somewhere out of direct sun and extreme heat.

No sunscreen, regardless of the SPF, will protect you completely and it should be only a part of your overall sun protection when enjoying the outdoors. Clothing, lip balm, hats, eye protection and avoiding the peak sun hours of 10:00am to 4:00pm should all be part of your plans to keep your skin protected as much as possible.

Get out this summer and soak up the sunshine – just be smart and safe when it comes to sun protection while you’re doing it.

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IT Band Syndrome

Iliotibial Band Syndrome is one of the most common overuse injuries for runners. The IT band is a ligament that runs down the outside of the thigh, from the hip to the shin, helping to stabilize and mobilize the knee joint. If it becomes too tight or inflamed it can cause friction on the knee and discomfort. The condition can cause pain while moving the knee that become so severe it can sieline a runner for weeks or even months.

 

The main symptoms of IT band syndrome are:

 

  • Pain in the knee area, usually specific to the area on the outside of the knee joint; this is where the IT band will be rubbing and causing friction when the joint moves during running.
  • Tenderness of the area on the outside of the knee joint.
  • Tightness or a feeling of reduced flexibility in the thigh, hip or knee.
  • Pain while cycling. The motion of cycling can cause the IT band to become inflamed and painful as well.

 

Some contributing factors to IT band syndrome are:

 

  • An imbalance in the hip and thigh muscles. If the muscles that surround and support the hip structure and the Iliotibial band are weak or imbalanced, the IT band can become tight.
  • Increasing run distance or speed too quickly. A training schedule that is too aggressive with increases can place significant stress on joints, muscles and connective tissue.
  • Running on uneven or hard surfaces. Surfaces that are “banked” or consistently uneven can cause the angles of the joints to increase, causing excess stress on placement of the foot, knee and hip.
  • Footwear that is unsupportive or improperly fitted can contribute to biomechanical issues that can cause IT band syndrome.

 

Treatment and Prevention

 

Treatment of an acute flare up of IT band syndrome, and understanding how to prevent it, is important for recovery and to ensure that the runner can make a full recovery. IF IT band issues are left untreated, they can progress from being a concern only while running to being experienced in day to day activities such as walking and sitting.

 

Treatment options for Iliotibial Band Syndrome include:

 

  • Rest. Immediately reduce the mileage that you are running (or cycling). In many cases, completely stopping all running for a period of a few days or weeks may be necessary.
  • Massage. Either self massage with a foam roller or external massage by a Registered Massage Therapist or Physiotherapist can help to encourage the tight IT band to release.
    • Foam rollers are used by lying on your side with the foam roller positioned under your thigh (your thigh will be resting on top of the roller), perpendicular to your leg. Make sure the roller is a few inches below the top of your thigh area; using your arms as support, slowly roll your body forward, allowing the roller to move down your thigh. This may be quite uncomfortable at first as the IT band is tight. Move slowly, taking care to ensure proper form.
  • Stretching. Make sure that proper and adequate stretching for the hip, thigh and low back muscles is a part of your running routine can help alleviate, and prevent, IT band syndrome.
  • Have your running gait (biomechanics) assessed. A therapist will be able to assess your gait and help you correct any imbalances in technique or muscle strength and / or weakness. A foot analysis to see if orthotics would help can also be done.
  • Warm up. Warming up before running can help the muscles and connective tissues to be less tight and prone to injury.

 

With some care and attention, the Iliotibial Band can recover fully from an acute flare up of inflammation or tightness. Seek out therapeutic guidance if it does not resolve itself with these tips or if it is an ongoing concern for your lifestyle.

 

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Runner’s Knee

runners knee

‘Runner’s Knee’ is the nickname given to the condition Patellofemoral Pain Syndrome (PFPS). It is a common issue amongst runners, both recreational and competitive. Generally characterized by pain or discomfort where the kneecap (patella) rests on the thigh bone (femur), it can range from mild to severe in the level of pain that it presents with.

 

It afflicts almost twice as many women as men; this is thought to be due to the tendency of the female hip structure to be wider, resulting in more of an angle of the thigh bone from the hip to the knee. Younger runners also tend to be more affected although the reason for that is uncertain.

 

Biomechanical issues are often to blame but other likely cause are: tight hamstrings, poorly – or improperly – conditioned quadriceps, or other muscle imbalances.

Quadriceps that are too weak to support the patella can lead to improper alignment and tracking. Tight hamstrings can pull, placing pressure on the knee and causing pain and discomfort as well. Having a professional assessment, treatment and exercise prescription can help with these concerns. Adding stretching and strengthening exercises is a proven method to treat PFPS.

 

Symptoms

Some of the most common symptoms of PFPS are:

  • Soreness or tenderness behind or around the kneecap, often around the center of the kneecap.
  • Pain in the back of the knee.
  • A sense of weakness or instability; like your knee may “give out”.
  • Sharp pain in the kneecap when going up stairs or hills.
  • Dull, aching pain with movement.

 

Prevention and Treatment

  • Run on softer rather than harder surfaces if you can.
  • Reduce your mileage and intensity if you are experiencing pain.
  • Avoid downhill slopes and deep knee bending activity until the pain subsides
  • Ensure that you are stretching properly and enough. If you aren’t sure about how to stretch or what muscles to pay attention to, speak to a professional.
  • Strengthen your muscles and maintain the strength. Again, if you are uncertain where your imbalances are; talk to a sport medicine therapist, physiotherapist or certified personal trainer for assistance.
  • Check out your footwear: if your shoes are older or worn, some attention here may make all the difference to your PFPS. Runners who put a lot of miles of their shoes need to replace them more often – remember, it’s not just how long you’ve had your shoes but how much you use them. Specialty running shops are great for advice on different types of shoes for a variety of needs and foot types.
  • Consider orthotics and having a professional gait analysis done if new shoes don’t help.
  • Have your technique assessed for movement imbalances. Having a Physiotherapist or Sport Medicine professional assess your gait (while you are actively running) can help to spot issues that you may not be aware of.

 

While Patellofemoral Pain Syndrome is a common and disruptive issue for many runners, it can be effectively prevented, managed and treated.

Happy and healthy running!

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Vertigo Treatment

What is vertigo?

Vertigo is a particular type of dizziness that makes you feel like your environment is moving around you, and it is often accompanied with feelings of nausea. Vertigo and dizziness are symptoms that can be related to a variety of health issues, including cardiovascular disease, anxiety, neurological disorders, visual deficits, viruses, or vestibular dysfunction.

Vestibular Rehabilitation

Do you ever feel like the room is spinning around you, or do you feel dizzy and nauseous when you change positions and roll over in bed? Do you experience difficulty with balance or a fear of falling? If so, vestibular rehabilitation can help you.

What is the vestibular system?

The peripheral vestibular system involves the anatomy of the inner ear. Our inner ear detects static, linear, and rotational movements of our head. The vestibular system gives sensory information to our brain about where our body is in space, so it plays an important role in balance. It also communicates with our eyes, through the vestibulo-ocular reflex, to help stabilize our vision while our head is moving.

What is Benign Paroxysmal Positional Vertigo (BPPV)?

BPPV is a common, and very treatable, cause of vertigo which stems from the vestibular system. BBPV is when the crystals in the inner ear are dislodged and are free to move around inside the inner ear canals. The crystals move when your body changes position and they stimulate nerve cells that give your brain incorrect information about where your body is in space. This causes a sensation of vertigo, nausea, and abnormal eye movements. BPPV can easily be assessed and treated within only a few physiotherapy sessions. Since BPPV is benign, it can be assessed and treated at any time, even if you haven’t had an episode of vertigo that day. Treatment includes a variety of manual repositioning techniques, accompanied by a personalized home exercise program to improve your balance, decrease your symptoms, and increase your confidence to move through the world without fear of vertigo.

Who can help me?

Jennifer Mildon, one of our Physiotherapists at Diversified, has a special interest in vestibular rehab and has completed post graduate courses in Introductory and Advanced Vestibular Rehabilitation. If you experience any of the symptoms discussed above and are interested in having an assessment, please request a vestibular session with Jennifer when you contact the clinic. She kindly asks that you arrange travel plans so that you will not have to drive home after your session. You are welcome to bring a friend or loved one with you to your appointment. If you are still not sure whether or not vestibular rehab would benefit you, free five minute consultations are also available upon request. We look forward to hearing from you soon!

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Gardening Guidelines For A Healthy Spine

It’s that time of year again when the garden beckons for our attention! After a few months of inactivity – for the garden blossoms and your outdoor gardening activity – it’s easy to overdo it when you do get back outside.

 

Here are a few things to keep in mind as you venture into the wilds of your yard this spring:

 

  • Avoid bending with your low back.
    • Squat with your knees, or kneel down on both knees with one arm out creating a “tripod” effect for stabilization. Or better yet, sit on a small stool or using a kneeling bench for comfort on your knees
  • Use caution when pulling on stubborn weeds.
    • Sudden jerking or twisting motions as roots give way can cause problems with your spine.
  • Carry heavy or awkward objects close to your body.
    • “Hug” items in tight to you. Keeping the load close to your center of gravity reduces the risk of strain on your neck and back.
  • Stay hydrated. Wear a hat and sunscreen.
    • You are expending energy, remember to drink water often. While the sun may seem weak still in the early season, even mild sunlight can cause damage if you’re not careful.
  • Stretch often and take movement breaks as much as you can.
    • Staying in one position for long periods of time isn’t healthy for your body. Remember to stand up and stretch every now and then. Take a stroll along your yard to keep joints moving and limber while you admire your work.
  • Be body aware.
    • Be aware of your posture and use good placement. When mowing the lawn, stand upright and maintain good core body position. Rake using both arms for a balanced impact on your body.
  • When shovelling, point your feet where the dirt goes.
    • No twisting and turning while you toss those shovels of dirt out of your way. As a rule of thumb, toes always point in the direction you are throwing the dirt.

 

With some attention to alignment and proper rest breaks, your forays into the garden this spring can be injury free for your spinal health.

 

If you do notice any twinges or pains that don’t go away after some rest and stretching, consult your medical professional such as a Chiropractor, Physiotherapist or Registered Massage Therapist to help with assessing your body’s needs.

 

Enjoy the gardening and stay healthy!

 

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Ouch! Is It A Strain or A Sprain?

When an injury occurs, it can often be difficult to determine just how severe an injury is – or even what type of an injury you have. Strains and sprains are similar but different and they can be hard to assess. A sprain or a strain of a muscle can be so intense that it can easily mimic a fracture of a bone. Even trained medical professionals will often have to rely on imaging to help them make an accurate diagnosis.

There are some common signs and symptoms that each of these injury types have that can help you in assessing just what type of injury you may be dealing with.

Here is a quick overview of what to look for:

Strains

 

  • A strain is a stretching or tearing of a muscle or tendon. Tendons are the connective tissue that connect muscle to bone.
  • There are two main types of strains: chronic and acute.
    • Acute strains may happen when slipping or falling on ice, jumping or running ballistically, an awkward bend or movement during lifting a heavy object’
    • Chronic strains happen over time, occurring from repetitive use activities such as golf, tennis, rowing or other sports.
  • Common symptoms include:
    • Pain
    • Swelling
    • Muscle spasms or soreness
    • limited ability to move the affected area

 

Sprains

 

  • A sprain is the stretching or tearing of ligaments. Ligaments are the bands of fibrous tissue that connect bones to each other throughout the body. They are most often seen in joints that have multiple normal ranges of motion such as ankles, knees, wrists and shoulders.
  • Commonly caused from an acute traumatic injury or the extreme sudden stress on a joint.
  • Patients often report hearing a “pop” or “crack” at the time of injury. It’s this that can cause the confusion between a severe sprain or a break. Medical imaging is often necessary to rule out a fracture.
  • Common symptoms include:
    • Pain
    • Swelling
    • Bruising
    • Limited or complete inability to move the joint or bear weight

 

When to seek immediate medical attention for a suspected strain or sprain

 

If you are experiencing any of the following, an urgent trip to a medical professional is your best course of action:

 

  • Numbness or loss of circulation in the affected area
  • Inability to walk more than a few steps without severe pain
  • Inability to move the affected joint area
  • Pain directly over the bone

 

Strains and sprains can range from mild, requiring no medical intervention, to sever, requiring surgery and rehabilitation to heal properly. If you are in doubt, let a professional assess you and determine what course of action is best.

 

For mild to moderate strains and sprains the initial course of treatment is home care and includes:

 

  • Rest: stay off the affected joint and allow the area to rest.
  • Ice: cold helps to reduce swelling and inflammation and reduces pain. Apply ice in intervals of for 10-20 minutes, repeating for the first 2 to 3 hours immediately following the injury.
  • Compression: To help with swelling and to assist in stabilizing the joint, you can use an elastic bandage to compress the area. Be sure not to wrap too tightly as you want to ensure proper circulation. If wrapping causes an increase in discomfort, numbness or if swelling increases, loosen or remove the wrap.
  • Elevation: elevating the injured area (above the level of your heart) will help with swelling and discomfort.

 

Most mild to moderate strains and sprains heal on their own with some care and attention as noted above but if you are not seeing some improvement in pain and the ability to move and bear weight in a few days, you may want to see a medical professional to assess the injury.

 

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Rheumatoid Arthritis

Rheumatoid arthritis has taken a step into the spotlight for many during the Winter Olympics. Canadian athlete, Spencer O’Brien (snowboard) has spoken openly about her journey with a diagnosis of rheumatoid arthritis and how it has affected her life and sport. Debunking the misconception that arthritis, in its many forms, is a disorder of the older persons, her struggle is one that many can relate to on some level.

So what is rheumatoid arthritis?

Rheumatoid arthritis, also referred to as RA, is an autoimmune disorder, occurring when a person’s immune system attacks its own body systems. Unlike osteoarthritis, rheumatoid arthritis does not cause the same type of wear and tear damage to the joints in the same way. The damage inflicted by rheumatoid arthritis is caused by swelling of the linings of the joints of the body. This can result in erosion of the bones and joints and can often cause joint deformation.

It is a chronic, inflammatory disorder that can affect much more than just your joints though. It can have a significant impact on a person’s entire body; including the heart and lungs, circulatory system, skin and eyes. Approximately 40% of people with RA experience symptoms that don’t involve joints.

Risk Factors

Gender plays a role in te disorder. More women than men develop rheumatoid arthritis and they tend to be more severely affected by it. They also are more likely to develop the disorder at a younger age.

Genetics may be a factor. If you have a family member with RA, you are at a higher risk for developing it yourself. however, the science is still out on whether there is a specific genetic cause for the disorder. A genetic predisposition to sensitivity of certain environmental factors, such as viral or bacterial infections which are suspected to trigger the disorder, can play a role in your risk factor.

Symptoms and Diagnosis

Depending on what areas of the body are affected primarily, the symptoms do vary but generally include the following:

–           Swollen joints that may also be warm and tender

–           Stiffness and reduced range of motion in your joints; especially after inactivity or in the morning

–           fever, fatigue, weight loss

 

The symptoms tend to start in the smaller joints and spread to larger joint areas over time as the disorder progresses. Symptoms may almost seem to come and go and be in flare ups rather than being consistent and progressive in intensity.

Your physician may use a number of diagnostic tools to assist in determining if you have RA. Blood tests, imaging tests and a physical examination of symptomatic areas are a few tools that are used.

Treatment

While there is currently no cure for Rheumatoid Arthritis, early diagnosis and aggressive treatment can be highly successful at reducing the impact this disorder can have.

The goal of treatment is remission: achieving a state where the activity of the disease is low or even gone. The earlier that treatment is started, the more that remission can be attained.

Prescription medications are often used to help reduce the symptoms and discomfort associated with the disease. Therapy is often helpful in managing the progression and assisting in performing daily tasks that can become more difficult as joint flexibility may be reduced. In cases where joint degeneration or alteration has occurred, surgery is also an option that is explored.

 

For more information and education about Rheumatoid Arthritis, check out this helpful link. If you are concerned about your joint health or have questions about RA, make sure to follow up with your primary care provider. Joint pain and stiffness doesn’t have to be something that you just learn to live with.

Yours in Health,

Diversified Health Clinic

 

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