Can a Sports Watch Give You Carpal Tunnel Syndrome?

A couple months ago, I started experiencing some weird sensations in the tip of my thumb. It initially occurred when I was harvesting okra from my garden. It almost felt like my finger was pricked by a splinter, and was a bit tingly. It felt like teeny tiny electric pulses concentrated in my fingertip. When I carefully examined my finger, I saw no signs of a splinter, but more of a pink spot. Then I thought to myself that perhaps it was an insect bite. I decided to watch it for a few days to see what would happen. 

Day after day, it was the same feeling. It felt like a part of a splinter was left in my finger coupled with little electric pulses. This went on for 3 weeks. By that time, it started to skip around to different spots on that same finger. I was definitely able to rule out a splinter at that point because it's not possible for it to move to another spot. I did some online research and I saw mentions of nerve problems associated with diabetes as well as carpal tunnel syndrome. I was able to rule out the diabetes part, and the carpal tunnel had me confused since my wrist seemed fine. 

After going into 7 or 8 weeks of this, the tingling sensation started to jump to a couple other fingers on the same hand. Things started getting uncomfortable at this point so I started to get desperate to get to the bottom of it. I knew I have a an upcoming appointment with my doctor, so I decided to wait out the week before I was going to see her. I did one last bit of research and wondered if a sports watch could cause CTS. After all, I do wear my sports watch during every waking hour and also to bed to track my sleep. The only time I ever really take it off is when I have to shower or enter water for any reason. There was no real evidence that this was the case, until I decided to try something. I took the watch off and within an hour, the electric sensation started to spread throughout my hand and wrist. 

I was so shocked and realized that the watch was the culprit. I saw my doctor the next day and explained what had been going on. She confirmed that it sounded like a mild case of carpal tunnel, and suggested keeping the watch off for a while. She told me if I absolutely couldn't live without it to wear it on the opposite wrist and be sure to not wear it at night. I took her advice, and I now feel 100% relief. I am no longer having any uncomfortable sensations in my fingers or wrist. 

If you wear a sports watch all the time, I highly recommend that you don't wear it as tight if you can help it. I have very tiny wrist, so in order for it to stay put, I pretty much have to wear it on the tightest slot. I left the watch off for a few days, and have started back wearing it on the opposite wrist being sure to leave a tiny gap so that this does not happen again. In the event this happens to you, I suggest taking Ibuprofen only as needed, keep your wrist elevated when you can, limit time on devices, and keep the area warm. Cold temperatures will set it off easily. It's all about resting your hand as much as possible. 

Thank you so much for stopping by today! 

What Does Family Medicine Consist Of?

The concept of the family doctor is strongly linked to the origin of family medicine. Advances in society, technology, and medicine have made this specialty to be seen more as integrative medicine, which means that the doctor is close to the patient and his family, and applies multidisciplinary with a team of professionals from different areas. 

The Entire Family 

Family medicine is dedicated to answering continuous and integral health problems of adults and children together as a family, considering the bio-medical, psychological, social, or spiritual to deliver a diagnosis. The family doctor treats all types of patients, whether they are healthy or sick people, and is present throughout the patient's life cycle (from newborn children to the elderly) to promote healthy lifestyles and preventive measures to take care of their health. Dr. Francene Gayle is one such physician.

The Specialists

Specialists in this area are often the first contact for patients. They work in an organized manner together with other professionals, acting as the family's medical team to guide what to do, and where to go, if they need to be referred to the corresponding specialist and, in this way, have adequate clinical control. In the United States, family medicine has its origins dating back more than three decades, but it has been in the last ten years when it experienced its greatest growth. The family doctor is the one who the patient can trust, know the reality in which they live with their family, solve their usual problems efficiently and help to choose, at a given moment, the place or specialist to handle their medical needs. 

Diagnosis and Treatment

Family medicine has become an alternative to address the health problems presented by individuals, which undergoes changes on all fronts: social, economic, cultural, and educational. It is for this reason that the specialist in this area will make a diagnosis to find solutions for major diseases and provide treatment, so the patient can feel better. Any patient who wants to take care of their health prevents the appearance of diseases, detects them early, or requires comprehensive management should consider going to a family physician, who will carry out therapeutic work to deliver a diagnosis and discuss further actions to be taken.

Family medicine is based on the values ​​and competencies of the specialty, deepening its knowledge and clinical skills for the benefit of the family, which guarantees close, warm, and highly decisive care. The family doctor is responsible for ensuring the long-term health of the same patient. This creates a relationship between doctor and patient essential to maintain good health and lifestyle. Your family doctor is the one who best knows the state of your health since he closely monitors and manages your well-being and how your environment can influence you. This, added to the knowledge the family physician has from the other branches of medicine, makes the work much more effective and helps you prevent diseases.

Conclusion

Now that you know more about this specialty of medicine, remember that you have the opportunity to receive care focused on your needs from your own family doctor. Put into practice healthy habits that your family doctor tells you, so you can prevent illnesses. Remember that your well-being is your commitment.

Why It Is Important To Speak Up When It Comes To Your Health

Have you ever felt like something in you is a bit off? Like you are off balance and can't quite figure out what your problem is? I went to my doctor a little over a month ago for my annual physical. I was actually 2 months off schedule since the pandemic came and knocked everything out of whack. Any time I have to go in to the doctor's office my blood pressure spikes a bit. I do check it at home regularly, and it is almost always right where it's supposed to be. The nurse always laughs and asks me if I am afraid of her, and that she doesn't bite. That usually calms me down, and my BP goes back down.

This last visit went a lot differently than normal. It was one of those very hot and muggy mornings, and I am normally the type of person who is always hot. I had to sip my ice water in the car, and put my mask on to enter the building. I went in, got registered at the front desk, and waited patiently to be called back. As soon as I saw the nurse crack open the door I felt my heart beat a bit faster, and I could feel myself trying harder to breathe. The mask doesn't make it any easier, but of course you still have to wear one.

Like with any visit, the first thing they do is check your weight and vitals. I decided to give myself a break with the weight since COVID-19 has been stressful and concerning. When the blood pressure cuff was placed around my arm, I had a bad feeling. My BP was 170/100! My heart rate was 117. I just sat there in shock as the nurse told me she would have to re-take my BP in a 5-minute time frame 3 times to get an average number between the three. Of course since it was within 5 minutes of the first check, it was still high at 155/95.

I felt a sinking feeling in my stomach and had those panicked breaths where I felt like I was gasping for air. My nerves were shot at this point. My doctor came in shortly after and was briefly updated on what was going on. We chatted about my overall well-being and how I was really feeling and I told her I was definitely better than I was in previous years dealing with extreme anxiety and depression. She figured that my elevated BP and heart rate were due to anxiety that were related to the pandemic, and the news regarding police brutality and racism. I mean, who isn't feeling a whole lot right now?

She highly recommended that I start a low-dose anti-anxiety medication to help me calm down, and hopefully that would result in my BP and heart rate regulating. I agreed. I don't know why, but I agreed. She wanted to see me back in 6 months to discuss how things end up going from taking the medication. I also had to wait for my lab results to see if anything else was wrong. Last year my cholesterol was high, and that is concerning since both of my parents were cardiac patients. I was warned of the possibility that if it was the same or higher, I would need to get on cholesterol meds right away.

I was diagnosed with thyroid disease about 5 years ago, and have been on medication to keep it regulated since then. Lucky for me, I've had very few symptoms that affect me. The only time I really did have anything that wasn't quite right was confused as being anxiety, when in reality I was having heart palpitations. Then the light bulb popped on in my head. The deep breathing and higher heart rate wasn't feeling 100% like anxiety, but more like heart palpitations. I decided to wait for my lab results to come back so I could see what my Thyroid-Stimulation Hormone (TSH) levels were. I just had a feeling something wasn't right.

What is so strange about the whole pandemic is that my life wasn't really affected a whole lot. Being home all the time, and homeschooling my son is my normal. Aside from not being able to find certain items at the store, things have been fine on the home-front. The only time I would get worked up is when I turned on the news. The state of the nation has been pitiful to say the least. Seeing so many families affected by job loss, kids not getting adequate education, and the state of financial crisis is enough to make anyone worry. But you know what? I still chose to find the good things to focus on each day. This made getting through these crazy months a lot easier. I have been surprisingly calm despite what was going on all over the world.

Enough about that, back to the lab results. They came in the next day, and to my surprise, the doctor was super happy to see how great everything looked. My cholesterol went down by 43 points! I had no idea it could drop that much in just a year. I can't tell you how relieved I was to get this fantastic news. I decided to really read through my results to make sure everything else was where it needs to be. I improved on just about everything! One thing did stick out to me though. My TSH level was at the top of the high number. That didn't sit right with me. Although it was .04 within the range, I was still concerned.

I sent a message through the patient portal to express my concerns about the TSH levels, and asked for my medication to be adjusted. I really feel like my elevated heart rate and BP was from heart palpitations caused by my thyroid and not anxiety. She agreed to step me up to 75mg from 50mg and have my labs done again in 3 months. After taking the higher dosage for 2 weeks, the palpitations subsided and I started feeling normal again. I definitely have not felt any anxiety or sadness. I knew I wasn't depressed, and was NOT about to take a drug that would be very hard to come off of.

This is what my blood pressure and heart rate look like now. 

I am happy that I decided against the anti-anxiety meds and opted to advocate for myself. While antidepressants are necessary for many people and do help a lot, I knew I didn't need them. I used to be one of those people who thought if a doctor tells you something, it's as good as gold and you have to listen. It's not always the case. Read over your lab reports, do your own research, ask questions and follow your gut. I'm so happy that I did! I will get my labs work done in the first part of September and go from there.

Thank you so much for taking the time to read this post. Continue to stay well, and wear your mask!

Trying To Adjust To Seeing Things Differently

For as long as I can remember, I have had excellent vision. I was the type of person to find the tiniest details in photos, artwork, or in any real-life scenery. People would always be amazed and say things like, "How on earth are you able to see that?" Fast forward to my middle 40s. Things aren't quite as crystal clear as they used to be. I have experienced more stress, anxiety, and depression in the last few years than I felt like I could handle. It was as if I cried and stressed the days away for 3 years straight. It was affecting my life in many ways.

One thing I noticed was that I had trouble seeing clearly when I was on the computer, phone or reading a magazine. I could barely see the menu when we were dining out in a restaurant. I spoke with my doctor and she suggested that I get some reading glasses. I bought some from my pharmacy and saw instant results. I could see clearly again! Reading glasses did the trick, and I could put them on and take them off as needed. This seemed easy enough. I did this for a little over a year and things changed again. I started getting headaches out of the blue and felt so much tension in my neck and shoulders.

I knew something wasn't right, and finally made an appointment for an eye exam. As soon as I walked into the building, I was overwhelmed. The friendly staff member directed me over to fill out the paperwork and select frames for eyeglasses. This was so different for me since it was the first time knowing that I was going to need glasses. The appointment itself was eye-opening. I had no idea how my vision declined as much as it did over the past couple of years. When the doctor switched different lenses to see if I was able to see clearly, it hit me-- my vision was terrible. It turned out that I had been compensating for what I wasn't seeing clearly or seeing at all.

The doctor then casually tells me, "I'm going to get you squared away so I'm writing you a prescription for bifocals." I was gut-punched because I really didn't know it was that bad. I took some deep breaths and sat with the specialist to get measurements done and make the selections that would be most beneficial to me. I was gut-punched once more when I got the final bill. YIKES! My husband was with me and calmed me down by telling me that I take care of everyone else, and it was time for me to take care of myself. I was told that my glasses would take approximately 2 weeks to be made and delivered.

For the next two weeks, I ended in so much pain from eye strain that led to neck and shoulder tension. I was a mess! I felt like I had to take 3 naps a day which is so not me. I'm thankful for my family who pitches in when I am down. They helped me a whole lot, especially the little one since he is with me all day long. I was super nervous when the call came in that my glasses were ready to be picked up. I sat at the counter with the salesperson and tried my glasses and sunglasses on. As soon as I placed the glasses on my face I felt really weird. I was like wait, I can't see properly. They told me because they are progressive lenses and I will have to get used to them.

As I left the building, I placed my pricey prescription sunglasses on and was hit with vibrant views. Everything around me was extra bright and colorful. I was seeing as clearly as I could when I was a teenager. I almost cried because I didn't realize how much I have been missing out on seeing. The eyeglasses have been more difficult to adjust to since I have to wear them all day long. I can't quite figure out how to tilt my head to be able to see up close. Even being on the computer has been difficult. I am still feeling a bit of fatigue, dizziness, and headaches, but they are supposed to clear up in the next week or so. I almost wanted to simply not wear them at all.

For now, I am thankful to be able to see details, vibrant colors, and having overall clarity. It will take time to adjust to wearing glasses, especially with different strengths for distance and close-up vision. I am going to be patient and know that I will be feeling like myself again soon enough. I'm sharing this post today for anyone who might be struggling with their vision and might not even know they are. Do not put off getting an eye exam! We aren't getting any younger.

If you have any advice for me, I'm open to it. Thank you so much for stopping by today.

What You Need to Know about Nasal Polyps

Have you been experiencing trouble breathing through your nose? Losing your sense of smell and taste? Perhaps painful sinus headaches that affect life, making daily activities difficult? These could be the signs of nasal polyps. Many patients begin to notice this issue after developing symptoms that won’t go away after a lengthy period of time.

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What Are Polyps?

Nasal polyps are grape-like growths that occurs in the nasal and sinus cavities. They begin to block the airways in the nostrils and can even begin to spread. Most people don’t notice that there is anything wrong until an obvious sign occurs, such as a persistent sinus headache or a rise in the number of times they get sick or develop an infection. The polyps grow gradually over time, which means that many patients don’t notice that they have a problem because the body has adjusted with the growth. Patients who have their polyps treated often note a major positive impact on their nasal breathing as well as other nose and sinus related symptoms.

How Are Polyps Diagnosed?

Patients with stuffy nose, diminished sense of smell and taste, postnasal drainage, etc may at some point make their way to an ear, nose and throat physician. Further evaluation will often involve a nasal endoscopy in which the doctor uses a small lighted rod to view back into the nasal passages. It is on careful examination, often with endoscopy, that patients are sometimes found to have nasal polyps. Further studies, such as CT scans, may be performed to help determine the extent of the polyps and the sinus blockage.

How Can Polyps be Treated?

Some polyps respond well to medications and others do not. There is an increasingly wide range of prescription nasal sprays and oral medications that can slow down the growth of polyps and, in some cases, shrink them. On occasion, it may be recommended that polyps be surgically removed so that the topical medications can work more effectively to keep them from coming back. Fortunately, surgery for polyps has changed a lot during the past few years, and is now usually an outpatient, minimally-invasive procedure without packing, bruising, or splints, and only minimal discomfort while the healing process occurs.  Small stents are now available that can be implanted during surgery and give off anti-inflammatory medication for several weeks.

In any case, polyps should always be evaluated by an ear, nose, and throat physician. Some polyps – particularly those that occur on one side only – need careful evaluation to ensure that there is not a more serious condition present.

To get help with nasal polyps, contact of Dr. Samuel S. Becker, a sinus specialist located in Pennsylvania. He is also a Clinical Assistant Professor at the University of Pennsylvania and a board-certified specialist in otolaryngology. For more information about him, visit his website at www.beckerent.com.

When Your Double Chin Just Won't Budge

You lead a healthy lifestyle and are committed to taking care of your body. You understand that it is your temple and you want to last well into your golden years. That means taking the time to choose foods that are good for you, practicing portion control, and indulging in moderation. Exercise is also a key component of your daily regimen. You're doing everything you are supposed to do, but you have a problem that is beyond your control. It's your double chin. It just won't go away.

It's hard to find an exercise that can focus on this trouble spot. Your weight is under control and you're in good shape, but that loose excess skin and fat isn't going anywhere. You're tired of looking at it in the mirror. Fortunately, you have options that can help you to tighten up this problem area that bothers men and women of all ages.

Liposuction is One Popular Solution

If deposits of reluctant fat beneath your chin are the only problem, liposuction could be the best answer for you. Your plastic surgeon will make a small incision in a targeted area beneath your chin. A hollow tube that is referred to as a cannula will be inserted into the incision in order to loosen up the deposits of fat that have collected beneath your chin. The fat will be suctioned away and your incision will be closed. Expect the incision area to be sore for a few days following your procedure. Slight swelling and some bruising are normal as well. However, your double chin will be gone when you have fully recovered.

Consider Kybella

Kybella offers you a solution that is non-surgical when you want to do something about that pesky double chin. It is an injectable that can destroy the fat cells that have gathered beneath your chin. Kybella contains a synthetic form of deoxycholic acid, a substance that is naturally produced by your body on a regular basis. It helps your body to break down fat and absorb it when you eat. When it is injected in a concentrated from in the skin beneath your chin, it will effectively blast away those bothersome fat cells. The end result will be tighter skin beneath your chin. The treatment takes about twenty minutes. You may need up to six treatments for the best results. They will be spread out a month apart. 

A Facelift Could be Right for You 

If you are looking for a more advanced solution, a facelift could be the best alternative. You can choose a facelift that focuses on the lower portion of the face and your double chin or a full facelift that will pull up skin on the upper portion of your face as well. A consultation with your plastic surgeon will determine how to tailor your procedure to meet your needs. The underlying tissues beneath the surface of your skin will be reshaped, excess skin and fat will be removed, resulting in tighter, smoother skin on your face.

The Solution is Up to You and Your Surgeon

You need to think about what you want in order to improve your appearance. You know that you aren't happy with your double chin. Now you need to consider how involved you want your procedure to be in order to get the best results. If you are prone to severe scarring or allergic reactions, Kybella and other injectables may not be the best solution. If your face is drooping considerably and wrinkles are a problem in addition to a double chin, a facelift can do wonders. Something as simple as liposuction may be best if there is only a problem with excess fat beneath your chin. Research your options. Look at photo galleries. Review the procedures to know what you want. Consider the recovery process and downtime that will come with each procedure. If you want to be on the go as soon as possible, Kybella is the most practical option. However, Kybella will not produce instant results. You will need to be patient. The results from a facelift and liposuction will be noticeable sooner, but the recovery process is longer. Facelift will result in the longest healing period. You can expect bruising and swelling after your procedure. Choose the solution that will give you optimal results and make sure it fits your lifestyle.

Give Yourself the Profile You Want to See

Your tired of looking at your double chin in the mirror. You hide from cameras because you don't want any photos to capture how you look right now. You want to see smooth, tight skin beneath your chin. The best way to make any changes to sit down with a plastic surgeon in order to have a thorough evaluation. Treatment is different for each individual. It's not one-size-fits-all. What works best to treat another person's double chin may not work for you. Your research can prepare you to know your options, but it will be up to you and your surgeon in the end to choose the best path. 

Find Out What the New York Center for Facial and Plastic Surgery Can Do for You

Turn to the experts at the New York Center for Facial and Plastic Surgery to discover your options for your double chin. Put yourself in the expert hands of Dr. Andrew Jacono, plastic surgeon specializing in facelifts. 

With a wealth of experience and dual certification, he is considered a renowned source on a global level when it comes to facial and reconstructive plastic surgery. He has focused on procedures that are minimally invasive and non-surgical in order to enhance facial features. When you come in for your consultation, Dr. Jacono will sit down with you to discuss your concerns. Your facial features will be evaluated and your medical history will also be reviewed as a treatment plan is planned for you. Dr. Jacono will discuss all of your options so that you can make an informed decision. Learn more about Dr. Jacono and your alternatives by visiting http://www.newyorkfacialplasticsurgery.com.

Many thanks to Dr. Jacono for this informative guest post. 

How to Recover After a Breast Augmentation

In the event you are considering breast augmentation, you might want to read this guest article for some insight before you make a decision in regards to the recovery process.

Breast augmentation recovery needs patients to minimize their physical activities for about a week before resuming their daily activities. The amount of time and the downtime needed for a full recovery to take place depends on the incisions made, the implant size and if the breast implant was positioned below or above the pectoral muscle.

Breast augmentation is among the most requested cosmetic surgery, and continuous improvements are being refined so that women can undergo the procedure, recover and get back to their daily activities as soon as possible. Since the breast augmentation surgery and the results are the most crucial points, recovery is also an important step for the best results to be shown.

If you plan to go for breast augmentation, you may end up spending a good amount of time deciding on the surgeon to go for with the budget you have. These are important aspects of the surgery that should be considered, but you should also plan for the amount of time you need to take from work to heal in a good environment as you avoid any strenuous activity.

As you take your break, you need to be aware that you will not be seated or sleep for the entire week; you are allowed to do some small less strenuous activities, but you should also be careful to ensure that any activity you are taking will contribute positively to your recovery process.

If you are planning to get breast enhancement, you need to spend a good time studying about the surgery and the recovery timelines. Once you are aware of what to expect, and you prepare to follow the instructions of the surgeon, you will have a great chance of maximizing the chances of a great surgery that will give you satisfaction and confidence in your looks.

Subglandular versus submuscular placement

The position of the breast implant always revolves around two regions, below or above the pectoral muscle. This position is also dependent on the goals, lifestyle and other factors. The most invasive of the surgeries is the submuscular placement because this method requires the separation of the pectoral muscle for the implant to fit after the incision on the skin is done.

Submuscular placement is the recommended position for women who are not into physical activities that engage the upper body and women who also desire natural looks. As we have described, submuscular placement is invasive, and it requires downtime of about one week from any physical activity like jogging. After the week is over, the patient should avoid going to the gym or lifting any heavy object for about four weeks. But for patients who go for subglandular placement, they can get back to work after four days of rest.

Depending on the implant placement, healing garments also contribute to the rate of recovery. For instance, patients who have undergone submuscular placement should put on a 2-inch wrap bandage above the breast. Once the surgery is done, the implant will start to harmonize with the breast tissues and the muscles to gain a more natural appearance.

You might be shocked when you notice that your breasts are high even after a few weeks of surgery, especially if you have undergone submuscular placement. It is possible for the breasts to look high for a long period (2 to 3 months), but after the muscle traps the implant at this position, it will release it to fall into the pocket with time.

After a subglandular placement, the patient should wear a conventional bra that does not have an under-wire that hinders the implant falling into place. Take note of the position of the incision, because it plays a role in the recovery process.

Incision location

The first kind of incision we are going to look at is the inframammary incision which is done at the crease located at the bottom of the breast where the chest wall and the lower breast protrusion takes place. If this is the best position for the implant to be positioned, then you be advised to rest for at least four weeks before resuming your daily activities that involve the upper body.

During the recovery period, you should avoid lifting your arms over your head to avoid any strain from impacting the upper body, to allow proper healing to take place.

There are other incisions that do not need a lot of time for recovery. For instance, if the implant is placed through an incision that is done around the nipple, there is practically no body movement or strenuous activity that directly targets this location. An incision procedure that produces the last scarring is called a TUBA (transumbilical) placement.

In TUBA placement, an endoscope which is a surgical tool that has a thin pliable tube with a small camera on its end is used to place a deflated saline implant in the navel, through the incision made. A saline solution is added to the implant for it to get to the desired size.

The size of the implant

There are various sizes of breast implants, ranging from women who desire a huge burst, to women who want to achieve moderate alignment and any other size in between. The size you choose affects the recovery duration. For instance, larger implants exert a lot of pressure below the pectoral muscle, leading to stretching of the overlying skin. The net effect is a recovery that takes longer.

Do not smoke

We should all be aware that smoking tobacco has a lasting negative effect on our health. But it gets worse if you are smoking while going through a recovery that follows a breast implant surgery. Nicotine shrinks the blood vessels, which lowers the oxygen levels in the body organs. Since cells have to divide for the wounds to heal, they require oxygen which is delayed when you are smoking.

Conclusion

For more information on breast implant procedures to help you achieve your desired result, call Dr. Douglas Steinbrech, breast augmentation surgeon practicing in New York on (347) 983-9560. You may also log on to https://www.drsteinbrech.com and schedule an appointment in the New York or Beverly hills offices.

Age Old Solutions

Caring for an elderly relative can sometimes be a bit tricky. Not only is it difficult to see an elderly loved one’s health decline, but it can put you in an awkward position. Where you have the added responsibility of caring for someone that used to be perfectly capable of caring for themselves. But to help you out, check out the guide below provides solutions to the most common issues you may face when caring for an older relative.

Ensuring they eat well

One of the biggest issues that you may come across when caring for an elderly relative that their eating can become erratic. This can be due to things such as catching a virus like the flu. As older folks' immune systems are weaker than ours.

Or it could be due to other issues that affect the appetite, such as diabetes that isn't being managed properly. Or it may even, be symptomatic of depression caused by chronic pain, losing a long term partner, or living alone.

But what can you do for them if you have noticed that they are eating less and less? Well, firstly it's important that you get them checked over by the doctors to see whether there is an underlying medical condition that needs to be treated.

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It's can also help to go round to their house, or invite them over to yours and make a hearty home cooked meal to tempt them into eating something. It's likely that the company will help them with this as well. 

Ensuring their medical needs are met 

Of course, a very important aspect of caring for an elderly relative is ensuring that their medical needs are met. 

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This might be something as simple as helping them to sort their pills into the right compartments for the rights days each week. 

Or it could be more involved, doing things likes organizing a palliative nurse for end of life care. Or being an advocate for them with the medical profession. 

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But whatever you have to do, be sure that you listen to their wishes as much as possible and engage them in the process. As no one likes to feel as if they are out of control of their life, no matter what their age. 

Getting them out and about 

Something else that you need to consider when caring for older relatives is giving them a chance to get out of the house occasionally. It can be pretty grim to be stuck indoors all of the time, and it isn't likely to help them feel their best. 

Obviously, mobility is an issue for many older folks so you will need to consider this before you plan out any trips. 

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Consider your destination carefully and make sure that it does not include too much walking or difficult terrain. 

Also, you can use disabled parking stickers so you can park closer to the store, or attraction that you take them to. Or consider using a wheelchair, or motorized scooter for those whose mobility is severely inhibited. 

Posture Problems Sorted

Do you remember you mom telling you to sit up straight when you were a kid? Maybe you say it to your little ones now? But sitting or standing up straight is about more than just looking smart and attentive. In fact, having a good posture is intrinsically linked to your health. Read on to find out more.

Hunch Back

Now while you might start getting images of a certain cartoon character that lived in Notre Dame, most folks with hunched back are not quite such serious cases. Instead, the top portion of their back is rounded instead of straight which is mainly due to the way that they sit and stand.

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Ladies with a heavier chest can be at particular risk of this, because gravity cause a natural hunch in balancing out the weight that is there. But what can you do about this?

Well, for one it's a good idea to check the way you are sitting at your desk for work. Your spine should be straight, which often means there is a dip in the lower back and your chest is pointing forward. You can get special seat supports to help you train you back into this position.

It can also help you have some additional support in the chest region. So consider getting properly fitted for your bras. Or even using a posture correcting bra, that provides extra support.

Spine Curvature

Of course, not all curved spines are caused by sitting or standing in a slouched position. In fact, some spinal and postural issues have a more serious underlying cause.

One of these is osteoporosis which is when the bones in your body lose their density, so they are no longer able to support your body properly.

In fact, one of the most prominent symptoms of this disease is a curvature of the spine. That is why it is so vital to be aware of your risk of osteoporosis and start to address this early on in life. So when you get the age where this is an issue you have already being doing things to relieve or prevent it.

One of the best things that you can do it to ensure that you consume enough calcium. Which the body need for fortifying your bones. This can be found in dairy products, as well as oily fish like sardines, and a green vegetable like Kale.

You can also take supplements made from algae that combine calcium with magnesium for maximum effect. If you would like to know more about this, you can read the AlgaeCal reviews on Amazon, and see what real people think of them.

Forward facing head 

Another common posture issue that many people can suffer from is a forward facing head. This is when the neck is not in line with the spine. But tilts forward causing the head to be in extended position.

This can be rectified in a similar way to a humped back, by retraining the correct posture through physical therapy and yoga.

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However, this is something that can often be confused with one of the signs of Cushing's Disease. Which is a fatty hump on the back of the neck.

So if you do have any concerns about this, it is best to get it checked out with a medical professional before you take any action.

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Keeping Your Head with a Child in Hospital

Whenever someone in your family is sick, it can be difficult to deal with. But when it's your child who isn't very well, it's never easy to cope. If they have to have a stay in the hospital for a while, it can disrupt your whole life. It's a hard thing to get through, but there are things you can do to make things a little easier. If you have a child who needs to stay in the hospital for a bit, you can get through it with a few tips to help you approach it in a way that will allow you to stay as calm as possible. When you pack a bag, take the time to think about these important things.

Try to Be Present As Much As You Can

It can be hard to rearrange your life around a poorly child, but most parents want to be there for their parents as much as they can be. Your employer should work with you to ensure you can take off the time you need. You have the right to time off work to take care of a dependent during emergency situations. However, if you know that your child will be going into hospital soon, you might need to look at arranging compassionate leave. Speak to your employer as soon as you can to see what you can do. Being there for your child during their hospital stay will help them to get better, reassure them and you, and keep you involved in their care.

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Don't Be Scared to Speak Up for Your Child

When you're surrounded by medical professionals, it can make you a bit wary of voicing your opinion. After all, they're the ones with years of medical training and experience. But even though the doctors and nurses know what they're doing when it comes to treatment, you're the one who knows your child. If you can sense when your child has had enough or if they need something, speaking up for them will help them, and it's useful for the staff too. If you can offer information about how much they normally eat or sleep, or how they usually behave, it can help doctors and nurses to see if they're different from normal.

Ask Questions

Speaking up and advocating for your child is important when they're staying in the hospital. If you have any questions about what's happening, don't be afraid to ask them. It's important that you understand what's going on and perhaps that you can explain it to your child in terms they can understand too. Medical professionals should be willing to answer your questions, except perhaps in emergency situations when they don't have time. Make sure they explain things to you in words you can understand. They might be able to give you relevant literature to read or make an appointment for you to have a discussion later on.

Make Friends with the Staff

If your child is settling in for a longer stay at the hospital, getting to know the staff is a great idea. Having the nurses on your side can be useful if you need any favours. They'll always be ready to do their jobs, but it can't help to butter them up a little too. Plus, it's always good to show that you appreciate them, and it gives you someone to make friendly conversation with. Make yourself familiar with the different positions and staff members. For example, auxiliary nurse jobs are sometimes referred to as healthcare assistant positions. They help out doctors and nurses to perform various tasks. For example, they might help patients to wash and dress or go to the toilet. Just knowing who to ask for what can help to move things along quicker.

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Get Organized at Home

There's no denying that a hospital stay for your child can disrupt life at home. If you have other children, you need to juggle their care with your other child. There may or may not be another parent around to help you out. If you want to make things easier, you need to come up with a plan to keep things ticking along at home while things are a little different. You might not be able to keep everything exactly the same, but you can try to make arrangements to keep everything organised. It might help if you can get friends or neighbours to help with some things, like collecting your other children from school.

Keep Things Consistent

Staying in the hospital is a huge change for your child, and it can be upsetting. You can be tempted to let go of the usual rules and perhaps let them get away with things you wouldn't normally allow. But it's more helpful for you to keep your expectations consistent with what you expect at home. If your child is expected to be polite at home, they should be in the hospital too. Of course, you don't have to be too strict, and there are moments when they might not be feeling well when you might let things slide.

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Have Someone to Talk To

When you have a child in the hospital, it's also important that you have someone you can talk to. While you're not the one who is ill, it can be emotionally trying to deal with. You might have a partner you can talk to, but it can also help to reach out to other people. As well as speaking to family members and friends, you might like to talk to a professional. There might be someone at the hospital you can speak to or a charity you can call to have a chat with a volunteer. Sharing your feelings helps you make sure you don't bottle them up.

Educate Yourself

Learning as much as you can about the reason your child is in the hospital and the methods used to treat it will help you immensely. Firstly, you won't feel as lost when you're talking about their treatment with their doctor. You'll also be able to advocate for your child better if you're more aware of the options they have. Your child's medical team should be willing to help you learn more. You can also look for charities or official resources that might give you the information you need. There's usually plenty of information online, as well as people you can talk to.

Look After Yourself

It's also very important that you look after yourself so that you're able to be there for your child. While it might be difficult to do even basic things like eating or sleeping, it's essential to try and stay healthy. You may not want to leave your child's side, but try to make time for things like eating, washing, or just taking a breather. Don't neglect your own health in favour of your child's, or you won't be able to be there for them like you want to. At the very least, you can plan to eat with your child. Sometimes, you might be able to stay overnight with them too.

Bring in Home Comforts

Items from home can be helpful for you and your child. They would much rather wear their pyjamas than a hospital gown and might prefer to have some food from home too. If they have any special things they can't live without, make sure they have them. You can bring things to do, such as books to read or music to listen to. There can often be a lot of waiting around.

Hospital stays are tough for anyone, and it's even more difficult when your child is the patient. But if you prepare yourself, you can get through it.

Vitamin D Deficiency Update

Over three years ago, I had some lab work done at my doctor's office and it was discovered that I was vitamin D deficient. My doctor explained that this is very common in people of color and that our skin simply does not absorb vitamin D easily like a fair skin people. The normal range you should be in is 30-100. I was coming in at 12.5. I was placed on a high-dose supplement for 12 weeks and was rechecked. I then came in at 21, but my physician was not happy with that and recommended that I take a daily 5,000 IU D-3 supplement. 

I have been doing that for a full year and would notice a difference in how I felt if I skipped a few days to a week. Since taking the vitamin D supplement, I have felt a lot more energized. Also a lot of odd issues I was having like leg or foot pain, depression, and a few other things seemed to have lessened or ever disappeared altogether. It is amazing how your vitamin D level can affect your overall health. 

 

I went in last month for my annual physical including labs and my results were amazing. Everything came back normal and my vitamin D level is currently at 50! That is a HUGE improvement and proof that the supplement does actually work. I have even noticed my hair, nails, and skin look even healthier. I have been taking the brand pictured above that I purchase at my local Kroger store, but any kind will do.

If you find yourself feeling sluggish, depressed, achy or just off for no reason, chances are you might be vitamin D deficient. It won't hurt to try a supplement, even at a lower dose to see if it helps. I had such great results and figured I would share it with you all. Be well xoxo

Recovery Procedures After Giving Birth: What's Involved?

Aging and child birth are the two most common causes of vagina slacking or loosening. Vaginal tissue can stretch naturally and it will happen to most – if not all – women as they age at a varying degree. After giving birth, however, you may feel insecure about the stretching of your vagina. A Vaginoplasty can help tighten vaginal tissue effectively. Before you decide to do the procedure, however, there are a number of things you need to know.

When can Vaginoplasty be performed after giving birth?

You should at least wait for three months after giving birth before deciding to get a Vaginoplasty. Although the tissue around your vagina stretches during labor, it will tighten itself to a certain point afterwards. Letting the vaginal tissue heals for three months or more is always the best way to go.

After the three-month period, consult your surgeon and have a pre-operative measurement taken first. At this point, you can decide whether to go through with the process with the help of information you get from the surgeon.

Keep in mind that not every woman needs to have Vaginoplasty after giving birth. The decision is entirely yours to make.

Are there risks involved in the procedure?

Vaginoplasty can be taken as a necessary medical procedure or an optional aesthetic or cosmetic surgery. In both cases, you need to work with a reputable surgeon and gynecologist so that the procedure can be performed without any real risk.

Dr. David Ghozland, in one of his recent reports, suggested that the common risks that patients face when opting for Vaginoplasty are very similar to those of other non-intrusive surgeries or procedures. The risks of infection, scarring and mild pain are present. This is where working with the right surgeon comes in handy.

These risks are easily avoidable. Every part of the Vaginoplasty can be planned in order to have a successful surgery without its risks. It is also important that you go through a series of pre-operation examinations to determine if you are in the right condition for the surgery.

What about the costs of getting the procedure?

Cost is always a concern when it comes to medical procedures, especially in today’s economy. Vaginoplasty is among the many procedures that may be covered by your health insurance if it is a necessity or approached as a medical procedure. To know for sure if your insurance policy will cover the costs of Vaginoplasty, you will have to consult your hospital first.

As a cosmetic surgery, however, you may have to pay for the procedure yourself. Thankfully, Vaginoplasty is not expensive at all. The treatment can cost anywhere from $3,000 to $8,000 depending on a number of factors. Compared to the benefits, the procedure is certainly worth it.

Should you consider Vaginoplasty after giving birth? This big question is yours to answer. The procedure brings a lot of benefits, including better sexual response and increased self-esteem. Find a reputable surgeon with experience and do the pre-operation checks and consultations in order to answer this question based on your specific circumstance.

The Women's Roadmap To Health

National Girlfriends Day was earlier this month, but it's always a good thing to have a friend remind you about keeping up with your annual wellness check-ups. It's easy for time to pass you by or to just put it off. Joining forces with your friends can be the push you need to get things done. My doctor even has a group of girlfriends who all schedule their annual woman's check-up in the same week and get together in one evening for margaritas to celebrate each other getting their health screenings done. I think that is such a cute idea.

Check out the infographic below from Oscar Health Insurance Company for details on what specific screenings you should have done and when. They're a new company wanting to shake up the health care field and help their members be proactive about their health through their various incentives. If you're in these areas, check out their health insurance plans in New Jersey and New York. Feel free to share with your girlfriends and family members.

Go here for additional information. Be well! xoxo

Aging and Changing, Being 41

I recently turned 41 (gulp). It seems so strange actually writing that number as my age. I really don't feel that old. I don't even know how 41 is supposed to feel. I know one thing though; I'm surely not 20 or 30 anymore. Many things have changed and I have had to take steps to adapt. I went to the doctor earlier this year for a full physical. It had been a few years since I last had one. I admit, I was very nervous. So nervous in fact that my blood pressure registered a lot higher than normal. I have a terrible family history of heath ailments. What if I find out I am diabetic? What if I have high cholesterol? What if I do end up with high blood pressure? I was really afraid. I knew I had to suck it up and get checked out thoroughly.

It only took a couple days to get the first set of lab results back. I felt like I couldn't breathe when I saw the doctor's office phone number show up on my phone. My heart raced and I had to take a deep breath. My doctor informed me that I had a vitamin D deficiency. I am not surprised by that because it is very common for brown-skinned people to have that issue. For whatever reason, our skin does not absorb vitamin D from the sun like a fair-skinned person would. I was prescribed a once a week, 2 month supplement to boost my levels. I noticed that after 4 weeks of taking the supplement I felt different. I had higher than normal energy levels, my nails were stronger and my hair seemed to be growing overnight. Besides the vitamin D deficiency, the doctor informed me my hormone levels that control my thyroid were abnormal. She asked me if I had been experiencing any of the symptoms like rapid heartbeat, weight fluctuations, sweating, and several other things. I told her no and insisted that the test wasn't accurate. I think she sensed my denial and was kind enough to entertain me. She ordered that I retake labs in 30 days. I took time to research hypothyroidism in depth. I had a light bulb go off in my head. Thyroid issues are hereditary. Almost every woman on my mother's side of the family has been diagnosed and is being treated by medication. I also realized that what I thought was extreme anxiety I have been experiencing for about a year or so was actually heart palpitations. I called up my doctor and she was very polite in not saying, "I told you so". She assured me that being put on medication wasn't the end of the world and it would help my situation.

I have been on Synthroid for almost 90 days now and had my labs done a few weeks back to see of the meds are helping. It turns out that my hormone levels are normal and the medication is indeed doing its job. As much as I did not want to be put on any type of medication for the rest of my life, it is what it is. I have my health under control and will be certain to keep up with regular doctor visits to ensure it stays that way. I have advised a few friends who complained of fatigue, anxiety and weight fluctuations to go get lab work done. I have one friend who told me she found out that she too was vitamin D deficient. None of us are getting any younger so it is important to get into the doctor's office at least once a year.

Do you have regular check-ups/physicals with you doctor?

I used to think all dog people were crazy

If you told me 11 years ago that your dog was your child or slept in your bed, I would look at you like you were nuts. Growing up in my culture, dogs were taboo in the home. My parents discouraged animals of any kind and would not even visit people if they had a house pet. I did not have the desire to ever have a pet because of my upbringing. When our first child was old enough say the word "dog", she asked for one. I refused to entertain that idea. I told my husband that until we bought a house and had a fenced in yard, I would *think* about it. Of course, the time came that we got the house with the yard and the question came up again. I let my husband and first born have their way and we got a 3 month old long coat chihuahua puppy. He was kind of cute, I admit. It took me no time at all to end up falling in love with this little pooch known as, Milo. We raised Milo as if he was our child. Anyone who visited, even non-dog lovers couldn't resist Milo. He was a cute and sweet dog. He loved everyone except the postal service workers, FedEx and UPS delivery people and the occasional stranger. If he sensed you were not supposed to be around our home, he would let you know it!

Over the years, Milo has been a faithful companion. He was always with one of his family members. He did not like to be left out of anything that was going on. If my husband was outside doing yard work, Milo was there. If I was working in my office, he would nap at my feet. If the kids were watching television, Milo lounged on the couch or floor near them. He was a family dog.

About two months ago, Milo started coughing. It was the first time we had ever heard him do that. We watched him for a few days and decided it was time to get him checked out at the vet. After a thorough examination, x-rays and blood work, it was determined that he had congestive heart failure. At that time, his lungs were full of fluid and he had a heart valve infection. It also was discovered that he had an enlarged heart that was pressing against his windpipe. That was what caused him to cough. We went ahead and got him some immediate treatment and had him put on 4 medications as well as a low-sodium prescription diet. The prognosis was that he may do well on the medications and live a relatively normal life or the opposite. For the first two weeks being on the medication, we noticed a difference and he seemed to be improving. Unfortunately, that didn't last long. He was getting sick again. The coughing came back. It got to the point that he was having a hard time breathing normally. We tried him on another batch of antibiotics as well as his other heart medications and he did not improve. He worsened.

It came down to having to make that big decision. Do we keep watching him suffer or let him go be at peace? It was a unanimous decision by our family (minus William since he doesn't fully understand) that we would have him put down. I always used to tell the girls when Milo was younger that pets don't live for a long time. They aren't the same as humans. I guess we didn't realize that time would come so soon. Ten years flew by and we had to do the right thing for Milo. We spent all of last week saying our final goodbyes to Milo. We let him do as he wanted and fed him like a king. It was hard. We all cried. I cried so much that I couldn't recognize my own face. I did not know I could love a dog that much.

We officially had him put down on Saturday morning. It was so hard. Everyone was very upset, but we knew it was the right thing to do. I think that knowing what was going to happen made it easier to handle. Milo has given us over 10 years of unconditional love and loyalty. We were so blessed to have him in our family. He is gone, but will forever remain in our hearts and memories.

The hardest part now is all the little reminders of him around the house. I no longer have the need for baby gates when we leave the house. I don't have to worry about leaving certain things on the floor in fear he might tear it up. I still hear him though. I hear faint barks and whimpering. I hear the jingle of his collar tags and his nails on the floor as if he is walking around the corner. It feels like he's still here. I have called the kids Milo almost a dozen times already. It will take time. We will all heal. For now, I focus on how much better a person I am because of him. I also know that dog people are definitely not crazy. They have extra big hearts.

Rest in sweet peace, Milo Anthony. You gave us 10 awesome years! We know you are living it up with all your friends in Heaven ♥

What do you do when you are allergic to everything?

For many years now, our daughter Briahnna has been going through treatment for a variety of allergies. Her first 2 series of allergy testing revealed that she was allergic to all the elements dealing with the outdoors as well as dust, mold, pet dander etc.... Today we took her to get tested since it has been about 3 years and this time was a big shock to us all. She had 30 different allergens injected into both forearms. The left arm was all  foods and the right was pollen, trees and other non-food things. She also had a series of individual outdoor allergens injected via needles into her upper arm. It turns out that she tested positive for everything! 

 You see how raised her skin is? She is allergic to just about everything it seems including all pollen, mold, grass, weeds, trees, dust, pets, and virtually anything that floats in the air.

She never had food allergies before and now she does. Although her food allergies are not all at dangerous levels, it still surprised us since they are the everyday type of things. Now she can only incorporate eggs, potatoes, chicken and several other foods into her diet every 4-5 days. Other things like tomatoes, pecans, peanuts and corn should be avoided all together. We were told that the symptoms of food allergies can vary from headaches, sneezing, itching, nausea or upset stomach. It was recommended for Brie to start a food diary to see what type of reaction she has to the foods she is more allergic to. If they are something she can live with, she can continue to eat them. She made the joke that she would not have been offended if she was allergic to carrots, cucumbers or other foods she does not care for to begin with. The good thing is she will continue on the allergy shots which have helped her immensely. She will have to go from one injection each week to three. Thankfully she is very laid back and does just fine with that sort of thing.

I do recommend that if your child shows symptoms of allergies, you should get them allergy tested. It is so important to know the triggers so you can do your best to avoid them. We were also told that allergy symptoms change every two years.

Do you or your child suffer from allergies that require regular treatment?

Dental Tips for Children

Tooth decay affects children in then US more then any other chronic infections disease. Untreated tooth decay causes pain and infections that may lead to problems, such as eating, speaking, playing learning. Luckily there are things you can do to protect your child’s teeth. Dr Pankaj Singh, CEO of Arch Dental, answers parents’ most pressing oral health questions.

 · When should you start brushing your kids teeth? - As soon as the first tooth comes in you should be wiping down your kids mouth with a damp cloth. Switch to a soft kids size toothbrush as more teeth come in.

 · How much toothpaste should they use? What kind? – Just a pea sized amount of fluoride toothpaste will do the trick. Don’t use fluoride toothpaste until your kid is over 2. Stick to a pea-sized amount, kids who swallow too much fluoride before the age of 6 can have white spots on their permanent teeth! There are tons of flavors, from bubble gum to watermelon.

 · Do you need a fluoride supplement? - Probably not, especially if your water has fluoride. If you have city water, you can check your water districts billing statement for the utilities contact info. If you have well water you can have it tested at a lab; local health districts often have testing capabilities. Always check with your dentist or pediatrician about your kids fluoride needs before giving a supplement.

 · What are dental sealants? Should my kid get them? – Dental sealants are thin, plastic coatings that are applied to the grooves on the chewing surfaces of the back teeth to protect them from tooth decay. Most tooth decay in children and teens occurs on these surfaces. Sealants protect the chewing surfaces by keeping germs and food particles out of these grooves. They are best for permanent teeth – they should be applied shortly after the permanent back teeth come in, before they have a chance to decay. They last 5-10 years and should be checked by your dentist at your regular visit.

 · What should I do if my child’s permanent tooth is knocked out? - Find the tooth and rinse it gently in milk or saliva. (Do not scrub it or clean it with soap, use just water!) If possible, replace the tooth in the socket and hold it there with clean gauze or a wash cloth. If you can’t put the tooth back in the socket, place the tooth in a clean container with milk, saliva, or water. Get to our office immediately. The faster you act, the better your chances of saving the tooth.

 · What if my child has a toothache? - Call your dentist promptly. To comfort your child, rinse the mouth with water. Apply a cold compress or ice wrapped in a cloth. Do not put heat or aspirin on the sore area.

Dr. Singh, Clinical Director at Arch Dental Associates 

About Dr. Singh: Dr. Pankaj Singh is an innovator, educator, author and pioneer in the field of dentistry. With experience spanning over 15 years, Dr. Singh is a world-renowned dentist who’s taking the industry by storm. The founder and Clinical Director of Arch Dental Associates, Dr. Singh specializes in dental implants, sedation and restorative dentistry, dental sleep medicine and facial aesthetics. In addition to overseeing his three premier New York dental practices in Manhattan, Huntington and Garden City, Dr. Singh is an attending doctor and serves as Attending Faculty at LIJ/NS University Hospital in the Department of Dental Medicine and Oral Surgery. He is an editor of "Journal of Oral Implantology" and on the editorial board of various other publications. He has also served as associate professor in the International Dental Program at NYU College of Dentistry and is a past board examiner of the American Board of Oral Implantology.

Our experience with allergy shots

When my daughter Briahnna was about 7, she started suffering from severe headaches. It went from maybe 2-3 times a week to 24/7 over the course of a few years. We took her to the doctor and he recommended an MRI. It came out fine. He had her go through it again. Two tests later, nothing. He couldn't figure out what was causing it. He then sent us over to an Ear, Nose and Throat doctor. She has her first allergy test when she was about 10. Turns out she was suffering from all the elements in the air... dust, pollen, pet dander and everything else. She was put on allergy medication and it started to help. Her headaches stopped and she was feeling normal again. Well that lasted all of about 3-4 months. The ENT tried changing her meds and although it would work for a while, it eventually stopped. There was always the discussion about allergy shots and I was really not sure how I felt about it. I did know that I was really tired of seeing my child suffer like she was. Finally we gave in and started her on the allergy shot. She would go once a week and get check-ups to see how she was progressing every 3 months. Literally within her first 3-4 months there was a drastic change with the headaches. They were getting less and less. Now she has been going for the shots for about 3 years and lives headache free. It was one of the best decisions we could have made. I wish we did is sooner but like I said, I was very skeptical.

Do you or anyone in your family suffer from allergies? Do you get the shot?

Interesting...

This morning I had an appointment for my annual pap... fun times for women all over the world I tell ya!  Well my doctor informed me of a change that was made in regards to getting one done each year. She said that as long as you have never had abnormal results over the years that you only have to get it done once every 3 years. I was like Whaaaattt??? I dared not argue about that one. She also mentioned that it is no longer recommended for any females under 21 years old to have one even if they are sexually active. I don't know how long this has been in effect for but I will take it! Not having to get scraped and brushed for 2 years in between works for me. My doctor did mention that you can still get one done annually if you want to.

Have you heard about this? What are your thoughts?