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Men's Health


 

Four Important Facts About Men's Health

 

June is Men's Health Month - a time to raise awareness of preventable health problems and encourage early detection and treatment of disease among men and boys.

Consider these statistics:

  • 350,000 men die of cardiovascular disease each year.
  • More than 700,000 men are diagnosed with cancer each year; 300,000 of those cases will result in death.
  • 230,000 men are diagnosed with prostate cancer every year. It's the second leading cause of death in men.
  • More than 60% of adult American men are overweight or obese.

As part of an educational campaign for men's health, The Cleveland Clinic surveyed more than 500 American men ages 18-70 about their use of healthcare resources and found:

  • Only 3 out of 5 men get annual physicals
  • Over 40% of men only go to the doctor when they think they have a serious medical condition
  • More than half of men said their health wasn't something they talk about.

It's time for men to take a proactive approach to health - both physical and mental health. Here are four noteworthy facts that can be the starting point for crucial dialogue regarding men's health.

Fact 1: Men are less likely to seek healthcare than women.

Who doesn't love superheroes like Captain America and Superman? They're the paragon of toughness and grit, fearlessness and brawn. But as popular as these heroes are, their influence may have unwittingly created a problem in the healthcare field.

There's a culture- and media-driven expectation for men to be strong and, like superheroes, rarely show signs of weakness. This socially-ingrained mindset subconsciously trains men to believe that going to the doctor exhibits weakness. A survey conducted by The Cleveland Clinic confirmed this trend, finding that 40 percent of men go to the doctor only when they have a serious health issue, and never go for routine checkups. This number is far lower than women's frequency of doctor visits. Needless to say, it's a concerning figure.

Men also tend to exhibit a fear of diagnosis. About 21% of men admit to avoiding the doctor because they're too nervous to find out what might be wrong. It seems that the pressure to conceal weaknesses is so strong that it can even lead men into a state of denial, and again, this is a worrying statistic. To be clear: ignoring your medical problems will not make them go away.

This month, let's work together to turn this trend around and create a cultural shift where men don't find it embarrassing or emasculating to seek out medical help.

Fact #2: Prostate cancer affects one in nine men.

According to the American Cancer Society, there are about 175,000 new cases of prostate cancer diagnosed each year, and prostate cancer is the most common cancer among American men. Given these statistics, it's important to ensure that at-risk men are being screened for prostate cancer—especially considering men's known reluctance to seek preventive care.

On the bright side, however, prostate cancer typically grows slowly, so many cases don't require immediate treatment and aren't life-threatening. Still, the earlier prostate cancer is caught, the easier it can be contained. It's always better to be on the safe side.

Fact #3: Mental health is one of the most stigmatized issues affecting men.

Many men—perhaps more than we think—struggle with their mental health and the stigma that surrounds it. The American Psychological Association reports that 30.6% of men have suffered from depression in their lifetime. Again, men's hesitation to seek care may be worsening this issue.

Men are notorious for not talking about their feelings, and no, that's not just another stereotype. It's an actual trend psychologists have documented. In the eyes of many men, discussing emotions is just another form of vulnerability that can lead to discomfort. It can be scary for many men to begin sharing their feelings, but the payoff is worth it: men who express their feelings verbally are less likely to express them in other ways.

Talk to the men in your life. Encourage them to talk about their day, to tell you about their emotions, and to be open with you. They may be resistant at first, but persistence is powerful, and you'll be doing your part to improve men's mental health.

Fact #4: Men should be making better lifestyle choices.

The stats back it up: men drink more heavily and smoke more frequently than women. Habitual drinking and smoking can have severe health implications. Drugs and alcohol can cause issues ranging from lung and heart disease to liver problems to preventable accidents.

Men also tend to make less healthy choices in the kitchen. Women eat far more fruits and vegetables than men, while men prefer meat and dairy. Yes, we know we're starting to sound like a broken record about the impact of cultural factors, but it's likely that social norms are influencing this trend, too. Cultural expectations can play a subliminal role in men's dietary choices and can have consequences over time.

Partly due to health behaviors, men have a shorter life expectancy than women. This gap has only continued to widen over time, and men are currently expected to live 5 fewer years than women, on average. So if anyone asks why we need a month for men's health, this disparity in lifespan should speak for itself—men simply aren't as healthy as they could be, and it's time to fix that.

 


Dedicate More Time Towards Your Well-Being

 

This year’s Men’s Health Month focuses on the theme of a new decade. With a new decade comes the opportunity to be reflective and prospective and evaluate how we have been dealing with our health, both physical and mental. In general, men are half as likely to visit the doctor for a check-up as women are — over 7 million American men have not seen a doctor in over 10 years. Additionally, as a result of dedicating less time to their personal health, male life expectancy is about 5 years less than women. 

There are several times in his life a man should be getting routine appointments with his health care provider to ensure that he is maintaining good health, even if in “perfect” shape. Dedicating time for regular check-ups and appointments mean taking responsibility for your health and well-being, especially in the time of Coronavirus. Here’s a breakdown of each decade of a man’s life, and when he should be getting certain check-ups with his healthcare provider:

20s

  • Every year – a physical exam, blood pressure analysis, blood test & urine analysis, rectal exam, STD testing, self-performed testicular exam
  • Every 5 years – TB skin test
  • Every 10 years – Tetanus booster

30s

  • Every year – a physical exam, blood pressure analysis, blood test & urine analysis, rectal exam, STD testing, self-performed testicular exam, electrocardiogram (EKG) for heart abnormalities
  • Every 5 years – TB skin test
  • Every 10 years – Tetanus booster

40s

  • Every year – a physical exam, blood pressure analysis, blood test & urine analysis, rectal exam, STD testing, self-performed testicular exam, electrocardiogram (EKG) for heart abnormalities, prostate specific antigen (PSA) screening, hemoccult test
  • Every 5 years – TB skin test
  • Every 10 years – Tetanus booster With physician’s discretion – chest x-ray, testosterone screening

50+

  • Every year – a physical exam, blood pressure analysis, blood test & urine analysis, rectal exam, STD testing, self-performed testicular exam, electrocardiogram (EKG) for heart abnormalities, prostate specific antigen (PSA) screening, hemoccult test
  • Every 5 years – TB skin test
  • Every 10 years – Tetanus booster With physician’s discretion – chest x-ray, testosterone screening, bone density screening

During Men’s Health Month, it’s important to emphasize each of these screenings and check-ups. Each and every one is necessary for maintaining good health and being aware of your body. This decade, let’s decide to dedicate more time and focus to our health.

 


5 Tips for Men’s Health

 

June is National Men’s Health Month! Men’s Health Month is about encouraging men to care for their bodies by exercising, eating right, and taking steps to prevent disease. 

Here are five tips to get you started:

1. Tweak your diet. Focus on adding more veggies, leafy greens, nuts, and berries to support brain health and boost fiber intake. Add lean protein options like salmon and turkey to meet your protein needs.

2. Set some goals. Think about what you want to achieve. Do you want to lose weight, gain muscle, or eat more vegetables? Set small and attainable goals and consider working with a registered dietitian or doctor to make them a reality.

3. Get Active! Regular physical activity is one of the most important things you can do to be healthier. Moving more is a great start. A walk around the block is an easy way to begin. It’s okay to start slow and gradually build a routine that works for you.

4. Be informed about common health issues that are specific to men. Learn more about your health, know your numbers, and schedule an appointment with your doctor to monitor your weight, blood pressure, and other numbers like cholesterol and glucose to name a few. 

5. Don’t ignore your mental health! Be open to speaking with your doctor or a mental healthcare professional if you need to.

Bonus Tip:  Eating a variety of nutritious foods can support overall health. Here is a list of foods to start eating more often or incorporating into your diet:

  • Fresh fruits and vegetables
    • Add more berries for heart and brain health.
    • Frozen and low-sodium canned vegetables are good options also.
  • Whole-grain products, such as brown rice and whole-grain breads
  • Fiber-rich foods, such as beans and leafy greens
    • Beans are a great plant-based protein and fiber source.
  • Lean cuts of meat and poultry, such as skinless chicken breast and lean ground beef
  • Fish, such as salmon
    • Include sardines, tuna, and other fatty fish to increase your intake of heart-healthy omega-3 fatty acids.
  • Nuts and seeds
    • Eating a handful of nuts like walnuts or almonds daily may improve heart health.

Bottom line: Your health matters. Invest in yourself and make healthy living decisions to support your health and wellness for a lifetime.  

Get more information to help support your health on the following websites:

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org.

 


Worst Health Mistakes Men Make After 40

 

For many, your 40s are a time of feeling more comfortable and established, as you become more secure professionally and personally. But it’s no time to become complacent about your health, an all-too-frequent occurrence in this decade. Your 40s are a time when certain health problems can creep up—or be avoided by making healthy choices. We asked the experts what health mistakes men tend to make at this age and beyond, so you don’t have to. Read on, and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had Coronavirus.

1) Skipping Health Screenings

Men are more likely to get their teeth cleaned than visit their doctor. Heart disease, BPH, and high cholesterol tend to start appearing in middle age.

The Rx: Make your regular checkups!, They give doctors an opportunity to discuss overall health to help men take better care of themselves and prevent health problems.

2) Being Sedentary

Only about 5 percent of American adults get 30 minutes of exercise each day. Go against the grain: A sedentary lifestyle raises your risk of obesity and related illnesses, including heart disease, cancer, diabetes and stroke. 

The Rx: For heart health, the American Heart Association recommends that adults get 150 minutes of moderate exercise (such as brisk walking) or 90 minutes of high-intensity exercise (such as running or swimming) each week. 

3) Ignoring Chronic Pain

Maybe you were taught that boys don’t cry and that “rubbing some dirt on it” is a remedy for most problems. But we feel pain for a reason. When you have pain that doesn’t go away, chances are your body is trying to alert you to a problem. 

The Rx: If you have pain that recurs or won’t go away, don’t tough it out. See your doctor.

4) Not Minding Your Mental Health

Men ignore psychological pain even more than physical pain. Men in their 40s have the tendency to ignore their emotional needs, which leads to an increase in stress and stress-related illness.

The Rx: Acknowledging when you need support and seeking out the right mental health counseling for your needs is essential. 

5) Poor Posture

Back pain, specifically low back pain, can be caused by poor posture and weak abdominal muscles. And those are the specific areas that need to be targeted and strengthened to relieve the pain and prevent future flare-ups.

The Rx: The first steps in correcting this is to simply concentrate on sitting up straight and pulling your shoulders back and down when either sitting, standing, or walking, Also abdominal strengthening exercises as planks or ab crunch you can try at home.

6) Staring a Workout Program Too Fast

Along with new fitness activity comes a real risk for injury, which can range from fractures, sprains, strains, to knee and back pain.

The Rx:Warm up and cool down, We need a few minutes of warm-up time before any physical activity to get the blood flowing, and give the muscles and joints a heads-up that they’re about to be put to work, as cold muscles are much less flexible and much more prone to injury. At the end of a cardiovascular warm up, a few more minutes of muscle stretching is always recommended.

7) Not Getting Screened for Low T

For most men over 45, about four out of 10 suffer from Low T, Low testosterone doesn’t necessarily have anything to do with the physical ability to get or maintain an erection. It has more to do with low desire and libido. The good news is that this condition shouldn’t be anything a man feels ashamed of and it is very treatable.

The Rx: There are a number of natural ways to raise testosterone, including engaging in exercise several times a week, and weight loss for men who are overweight, A doctor may suggest starting hormone replacement therapy, which includes giving testosterone in an injection, patch, gel, or tablets to raise his levels back to a normal, healthy range.

8) Ignoring Prostate Health

Outside of skin cancer, prostate cancer is the second-most common cancer cause for men in the United States, with up to 1 in 9 receiving the diagnosis at some point in their lives, The great news is that most men have a high probability of surviving the disease, though as with many cancer types, that likelihood decreases as the disease advances.

The Rx:Men who receive regular checkups and prostate examinations after age 50 have a much higher likelihood that cancer would be discovered and diagnosed at an earlier stage. 

9) Smoking

Smoking isn’t just detrimental to your lungs, Your kidneys and bladder, your body’s filtration system, must process the toxins from cigarette smoke too. From the risk of kidney failure to multiple types of urological cancers, smoking is one lifestyle habit that really isn’t worth it. 

The Rx: Quit smoking now. If you don’t use tobacco, don’t start. 

10) Not Monitoring Blood Pressure

High blood pressure isn’t only bad for your heart, In fact, uncontrolled high blood pressure is among the leading causes of kidney failure in the United States.

The Rx: The American Heart Association recommends getting your blood pressure checked at least once every two years. If you start early enough, before problems arise, keeping your blood pressure at a normal rate and your kidneys in proper working order can be easily accomplished with lifestyle modifications.

11) Gaining Weight

Obesity is among the highest risk factors for a host of cancers, including bladder and kidney, Studies have shown that simply being overweight, not necessarily clinically obese, also increases risk.

The Rx: Simply paying attention to what you’re putting into your body can be a great start, This year, if you haven’t already, begin reading food labels. A good rule of thumb: if the package label contains ingredients you can’t pronounce, don’t buy it.

12) Not Eating Right

Our bodies’ organs simply weren’t designed to meet the demands put on them by the consumption of highly processed, high-sugar and high-fat foods, And when they’re forced to filter these substances long-term, the consequences can be severe and life-threatening.

The Rx: Focus on putting the most pure, whole foods into your body.

13) Not Getting a Colonoscopy

Colonoscopy is the best method to get screened for a very common but preventable form of cancer in the USA, Currently, 6 percent of individuals will suffer from this common form of cancer during their lifetime, which can be prevented if they have a proper screening. During colonoscopy, precancerous polyps in the colon can be removed before they become cancer and spread.

The Rx: The American Cancer Society recommends you start discussing screening for colon cancer with your doctor at age 45.

14) Not Wearing Sunscreen

Because many signs of aging are caused or exacerbated by sun damage, sunscreen is the best anti-aging treatment in your skin care routine, Most importantly, sunscreen is your first line of defense against skin cancer.

The Rx: Even if you’re sitting inside all day, you still need sun protection. By wearing a broad spectrum sunscreen every day, you can shield your skin from both UVA and UVB rays. They recommend choosing a high-quality, broad-spectrum sunscreen.

15) Sharing Your Wife’s Towel

Remember to never share towels. It’s easy to spread bacteria and infections, especially when they’re wet.

The Rx: Always keep track of which towel is yours, and don’t forget to switch it out for a clean one on a regular basis.

16) Using a Years-Old Loofah

Do you still have the same loofahs from your European vacation in 2015? You might be surprised to see what’s living inside. Washcloths and loofahs can harbor bacteria, mold and yeast, among other harmful things.

The Rx: Make sure you allow your loofah to dry completely each time and replace it frequently, If you cleanse with a washcloth, grab a fresh one every day and don’t use it on your face. This microfiber mitt removes dirt, oil and makeup with warm water alone. By eliminating the need for a cleanser, this tool protects the skin’s pH balance.

17) Jumping Onto the Latest Exercise Fad

A 40-year-old man, embarking on a fad exercise program is liable to injure his back or neck, The bones of most 40-year-old men are still as solid as they were at 20, and his muscles are often just as solid. But the joints that hold the spinal bones together—and the discs which act as cushions between those bones—are no longer nearly as resilient as they once were.

The Rx: Warm up, take any new exercise program slowly, and give your body time to recover between workouts.

18) Jumping Onto the Latest Fad Diet

Fad diets are designed to take off weight as quickly as possible. They often ignore the long term effects that might occur regarding both the brain and spine, A 40-year-old man embarking on a radical weight loss program is liable to make a nutritional blunder that may increase the likelihood he’ll suffer from brain problems like dementia later in life.

The Rx: Consult your healthcare provider before embarking on a new diet. Also, consider moderating the diet to make it less extreme, You should be suspicious of any diet that says ‘never’ or ‘always.’ For any diet, as in most things, balance is best.

19) Overusing Your Hands

A sudden increase or change in activity, like trying out a new exercise at the gym or using a computer leading up to a deadline, can cause tendonitis to flare around the hand and wrist, This can include trigger fingers, de quervain’s (tendonitis of the wrist) and sometimes carpal tunnel syndrome.

The Rx: Make sure to take breaks from activities that require constant or repetitive motion, and taking anti-inflammatories may help relieve symptoms if they become bothersome.

20) Ignoring Nail Fungus

If your toenails look odd because of thickening, lifting or color changes—it can be signs of infection. Both bacteria and fungi can cause nail infections and are very common in the environment, You can easily pick up a nail fungus, for example, at a swimming pool, from the gym floor, the dirt outside or even from a family member.

The Rx: Pay attention to nail health year round. If you observe anything suspicious, make an appointment with a dermatologist.

21) Neglecting Your Nails In General

Fungus isn’t the only problem that can plague your nails. Nails say a lot about health. For example, brittle nails can demonstrate vitamin deficiencies. Biting nails can open the skin under the nail, introducing bacteria, a fungus or yeast that can cause infection.

The Rx: Cut your nails regularly, and don’t be afraid to visit the nail salon (it’s 2020, after all). When cutting your nails, be sure to cut straight across, and file them into a square shape, not rounded. Cutting the corners off increases your risk of an ingrown nail.

22) Not Nurturing Relationships

Take a look at the ‘blue zones’ of the world—places where people live the longest. What characterizes them all is the fact that they are all bound by a strong sense of community. This diminishes stress and decreases the risk of chronic illness and premature death.

The Rx: Make the time to spend with that special someone in your life. Go kick a football with your son. Volunteer to help at your church. Every little bit helps. The effort does not need to be massive, but the result can be life changing.

23) Ignoring Diabetes

Have you been tested for diabetes recently? Are you sure? Untreated, diabetes causes sugars to build up in the blood. That damages arteries throughout the body, skyrocketing your risk of heart disease, stroke, vision loss and circulation problems that could lead to amputation.

The Rx: Get checked for diabetes or prediabetes ASAP. Follow your doctor’s recommendations for lifestyle changes or medication if necessary.

24) Not Staying Flexible

One of the biggest mistakes men can make as they age above forty is to not maintain their flexibility, Reducing resting muscle tension can improve your energy levels, raise your mood, and can contribute to making you more active.

The Rx: Maintaining flexibility can be done through regular stretching, or better, by including cross-training workouts that focus on eccentric (lengthening) strengthening like Pilates.

25) Eating Processed Food

After 40, the key is to cut out processed foods from your diet, Processed foods are typically loaded with artificial preservatives and additives and tend to be made from non-organic foods containing residues of pesticides. This, along with the addition of refined sugars, high fructose corn syrup, emulsifiers, salt and ethanol make for an unnatural dietary source which lacks proper nutrition.

The Rx: Cut processed foods out of our diet and replace them with whole foods. Our bodies need the vitamins, minerals, proteins, carbohydrates and fats from whole foods for optimal health.

26) Neglecting Your Brain

As we age, our brains shrink in volume, particularly the frontal cortex and hippocampus, areas involved in higher cognitive function and encoding new memories.

The Rx: It’s important to keep the mind stimulated, and one of the best ways to do that is with the brain training app Lumosity, This app is personalized and trains key areas of your brain. Just a few minutes a day can help your mind stay sharp and can even help you improve in certain areas.

27) Not Dancing

When you’re over 40, you can’t ignore any chance to get physical exercise. And what’s easier than move your legs rhythmically to the sound of music? Studies show that regular physical exercise can reverse the signs of aging in the brain with dancing having the most profound effect, decreases risk of dementia, improves your balance, reduces stress and helps you lose calories—and last, but not least, makes you a socially attractive person.

The Rx: Next time you hear some music, show your moves.

28) Neglecting Weight Training

We all know that cardiovascular training is good for the heart and helps keep weight off, but weight training is just as important, maybe even more so, Weight training has been shown to have similar cardiovascular benefits and can actually reverse age-related muscle loss. It burns fat, exercises all your muscles, including your heart, lowers blood pressure and improves blood flow to the brain.

The Rx: Aim to get 30 minutes of exercise most days of the week, including two strength-training sessions weekly.

29) Not Getting Your Hearing Checked

One condition that shows up in some patients over 40 is tinnitus, a challenging problem that has common symptoms like roaring, ticking, ringing, or whistling sounds in the ears, Sometimes, the symptoms of tinnitus can signify other health problems.

The Rx: Schedule a hearing evaluation with an audiologist, who can recommend treatment.

30) Ignoring Hypertension

A common trap for men is failing to seek medical advice, allowing ailments as hypertension and diabetes to gain an even stronger foothold prior to diagnosis and therapy, Older doesn’t always mean wiser, particularly when it comes to assessing your body’s issues

The Rx: Invest in a home blood pressure monitor and measure your blood pressure on a regular basis, ideally a few times a week. Monitors can cost between $40 and $100 on average, but your health insurance might cover it. If you see any significant changes in your pressure, consult your doctor.

31) Ignoring Enlarged Prostate

Over 40 million men in the U.S. suffer from enlarged prostate, also referred to as BPH (Benign Prostatic Hyperplasia), This can cause symptoms such as a weak urinary stream or frequent daytime urination. As men get older, the prostate continues to grow, and symptoms often worsen. This can result in the complete inability to empty the bladder, requiring a catheter or invasive prostate surgery.

The Rx: Worsening urinary symptoms are not just a normal part of the aging process, They can be a warning sign of bladder damage, and should not be ignored. If you have symptoms of BPH or urinary difficulties, see your doctor.

32) Ignoring Early Signs of Dementia

Dementia is most common in older age, but it can affect men as young as their 40s. It’s estimated that 200,000 Americans have early onset Alzheimer’s. 

The Rx: If you observe memory problems, write down the symptoms and contact your doctor for an evaluation. Dementia and other signals of cognitive decline should not be considered normal and irreversible, There is a range of treatments and therapies to be explored.

33) Not Getting Treated for ED

Don’t suffer in silence about erectile dysfunction—talk with your healthcare provider about it. More than your sex life could be at stake. Erectile dysfunction can be an early sign of serious health issues, including cardiac problems, diabetes and depression.

The Rx: If you have ED, see your doctor. Several effective therapies are available.

34) Not Getting Quality Sleep

Insomnia and poor quality sleep doesn’t just run the risk of making you irritable the next day. Without adequate sleep, your body can’t adequately repair itself; that increases your risk of health problems such as cancer, heart disease and dementia.

The Rx: If you’re having trouble getting seven to nine hours of quality sleep a night, talk with your doctor about it.

35) Eating Too Much Salt

High sodium intake is a risk factor for high blood pressure, which raises your chance of having a heart attack. Studies show that most Americans consume about 3,400mg of sodium daily — way over the recommended 2,300mg (about one teaspoon of salt).

The Rx: Don’t add salt to your meals. Avoid fast food and processed foods, which tend to come loaded with sodium. Inspect nutrition facts labels and choose products low in sodium.

36) Ignoring the Risk of Stroke

The risk of stroke increases as we age—and the vast majority can be avoided. The National Stroke Association says that up to 80 percent of strokes are preventable.

Remedy Rx: Keep your blood pressure down and weight in a healthy range. If you have high cholesterol, diabetes or AFib, get them under control—all are risk factors for stroke. Don’t smoke, and keep your alcohol intake under two drinks a day.

37) Drinking Too Much Alcohol

Excessive alcohol consumption increases the risk of cancer and heart disease. And you may be drinking more than you think. Experts recommend moderate drinking—defined as no more than two alcoholic drinks per day for men, and one drink for women.

The Rx: If you’re having trouble cutting back, talk with your doctor.

38) Stressing Out

Stress that’s left unchecked can contribute to many health problems, such as high blood pressure, heart disease, obesity and diabetes.

The Rx: Relieve stress by getting regular exercise, socializing and creating time for yourself. Relaxation techniques such as mindfulness can also help.

39) Ignoring Your Cholesterol Level

High blood cholesterol clogs arteries, increasing your risk of heart attack and stroke. Have you had yours checked lately? Your total cholesterol level should be less than 200 milligrams per deciliter (mg/dL), with an LDL of less than 100 mg/dL and an HDL of 60 mg/dL or higher.

The Rx: Experts recommend getting a cholesterol check every five years; older adults may need one more often. To keep your LDL (“bad”) cholesterol level down, eat a diet low in saturated fat, exercise regularly and maintain a healthy weight.

40) Eating Too Much Added Sugar

You’ve probably heard the new health maxim: Sugar is the new smoking. It’s not an exaggeration. Drinking sugar-sweetened beverages and eating a diet high in added and refined sugars increases your risk of obesity, diabetes and high blood pressure, which in turn raises your risk of heart disease and stroke. 

The Rx: Skip soda, fruit juices and other sugary beverages, and limit your consumption of added sugar by choosing whole foods and products that have little or none. As for yourself: To get through this pandemic without catching coronavirus, don’t miss this essential list: Most COVID Patients Did This Before Getting Sick.

 

 



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Most recent revision May 04, 2025 08:12:30 PM