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Mammary duct ectasiaSigns and Symptoms In most of the cases, female patients do not have any symptom. In few cases, women may present with nipple discharge, tenderness or inflammation of the surrounding region. In some cases, there may be a lump over the breast or the nipple may get inverted. Causes Exact cause of mammary duct ectasia is unknown. But few possible cause or risk factors have been proposed by the doctors : Increasing age - Probability of developing mammary duct ectasia increases with age. With ageing, the breast changes its nature. Glandular tissue is replaced by fatty tissue. This change may lead to duct ectasia. Smoking- Milk ducts are widened due to smoking. This increases risk of inflammation which may lead to duct Ectasia. Inverted nipple - Inverted nipple obstructs the milk duct. It may lead to inflammation followed by duct ectasia. Complications Complications of duct ectasia may be may be of varying severity. They are usually minor, but sometimes become serious. Localized discomfort- Discomfort occurs due to pain and swelling around the nipple. Nipple discharge - Ectasia is frequently associated with discharge of thick and sticky fluid from nipple. Infection- Bacterial infection may develop due to stagnation of fluid in the milk duct. If it is neglected, it may lead to localized collection of pus known as abscess. Abscess requires surgical treatment. Abscess is drained surgically. Diagnosis The doctor usually diagnoses duct ectasia by clinical examination. However, few investigations may be required. Mammography- X-ray of the breast tissue is known as mammography. It helps the doctor to evaluate the breast tissue. Ultrasound- Ultrasound enables the doctor to evaluate milk ducts beneath the nipple. Treatment Duct ectasia is usually relieved by treatment. Following are the treatment options : Medications: The doctor prescribes antibiotic therapy for 10 to 14 days. It may be accompanied by mild painkillers like ibuprofen, etc. for initial few days till the remission of the disease sets in. Most of the cases are usually relieved by medications. Surgery: If duct ectasia is not controlled with medications then the doctor chooses to remove the duct ectasia surgically. Surgery is required very rarely.  Self care measures Following self-care measures often provides relief to the patients. These remedies can be adopted at home. The patient may wear a breast pad or support bra. The patient may apply warm compression to the affected region. The patient must stop smoking. The patient may be advised to sleep on the opposite side of the affected breast. Female patients should be educated regarding mammary duct ectasia so that they can detect possible symptoms of duct ectasia themselves. This will help to prevent possible complications of mammary duct ectasia and early diagnosis will provide early cure.
Is circumcision a healthy ritual?Religious rituals and practices have been carried out since ancient times. Circumcision is a religious ritual that involves surgical removal of the prepuce of the human penis. Prepuce is the foreskin of the penis and during the procedure; the person performing the ritual opens, inspects and separates it from the glans. The process is painful and hence local or topical anesthesia is used to reduce physiological stress and pain. Circumcision is performed for religious as well as personal reasons and many times recommended medically for prophylactic or therapeutic reasons as well. Today's medical science makes use of this treatment for treating chronic urinary tract infections, refractory balanoposthitis and pathological phimosis. Circumcision is performed as ritual in many parts of the world. However, it is also recommended medically as protection against HIV infection. Circumcision-Is it Legal and Ethical? In the world over, the ritual or practice of circumcision is carried out on all types of people from neonatal stage to adulthood. While no significant risks have been noticed due to the practice of this ritual, rather some modest health benefits have come to the fore. The World Health Organization has recommended circumcision for male infants in parts of Africa where the children are more vulnerable to urinary tract infections. However, no other medical organization in the world has supported or banned the procedure. Over past few years, legal and ethical questions have been making rounds and many believe that consent should be taken before carrying out neonatal circumcision. HIV and Circumcision Benefits A Cochrane meta-analysis conducted in 2009 on sexually active African men have revealed that the ritual of circumcision reduces the risk rate of HIV infection by 38 to 66 percent among heterosexual men in a period of 24 months. That is why WHO has recommended circumcision in sub-Saharan African areas having high rates of HIV infection as a part of the comprehensive HIV program. Moreover, this process is more cost-effective as compared to other treatments and preventive measures recommended for HIV. Circumcision reduces the risk rate of HSV-2 infections and oncogenic HPV prevalence along with the risk of penile cancer and UTIs. Until now, there have been no concluding reports on the protective effects circumcision offers against other types of sexually transmitted infections. Circumcision is also recommended medically to children suffering from pathological phimosis and refractory balanoposthitis. Contraindications The literature worldwide review conducted in 2010 reveals that around 1.5 percent of the newborns face median complication when the process of circumcision is performed by trained medical providers. Only 6 percent children face severe complications with the common complications being infection, bleeding or removal of too little or too much of foreskin. However, the process does not cause any negative impact on the sexual functioning of an individual. Contraindications due to circumcision are also cited in infants having genital structure abnormalities right from the birth such as misplaced urethral opening, ambiguous genitalia or chordae. In such cases, the foreskin may require reconstruction through surgery.  It is contraindicated in premature babies and clinically unstable infants and it should also be avoided in children with family history of hemophilia (bleeding disorders). In such patients, it is important that the blood should be checked for its coagulation properties before attempting the procedure.
Expression forbidden! - Human emotionsSome people have a perpetual 'bee in their bonnets'! They maintain a demeanor and a mask which is virtually impenetrable. They are generally highly competent and efficient and occupy high positions of authority. They believe in living life set to a routine, and the worst part is that they expect others to adhere to it as well! God help those who have a boss like that, as their immediate liberty is at stake, and unless they are honing to be perfectionists, life is going to be a series of disasters with Captain Ice around! Nothing wrong with perfectionism per se, but when someone is a hard task master then he could well earn himself the epithet of being "a crashing bore," especially if he doesn't allow others to express themselves properly. Take a more intimate scenario - Mr. Bright Harry meets tepid Sally. The sparks fly only on Harry's side with Sally stonewalling his every effort to get to know her mind, body, and soul. A tough ask for poor Harry, as he is yet to touch first base with Sally. Know what? They have been married 5 years and she seems to be fond of him, yet has never as much admitted it to him. Quite frankly, the two could pass off for siblings rather than 'man and wife.' Why are some people such rotten spoilsports, especially where emotions are concerned?  It may well be a natural mindset for some to have an emotional guard up and emote, or have an emotional connect only with certain types of people. Fair enough and good show, we say! After all one can't be wearing one's emotions on a sleeve or you end up been taken advantage of. That's a mask that most 'tough guys with soft centre' wear anyway. Nowadays with the rules being somewhat relaxed with men been given liberty and allowances to display their gentler feminine emotional side, we find men going over the top with the sheer display of emotional expression. One is at sea wondering which one was worse off-the tough, cynical cop look or the "let me weep my heart out for you" kind of contrived emotion. That apart, it is bad enough for us having to contend with a person who has difficulty with expressing himself properly. We don't mean articulation or even well-developed linguistic ability - we mean being able to be spontaneous and congenial and a little forthcoming and nice to be with sort of an emotional person. So, unless someone has a romantic angle towards this guy (there are weirdoes all over the world, who go asking for it!) or girl, he is going to be feared, hated, despised, unloved, and uninvited by everybody. So why do people behave like they are going to be flogged for even attempting a ghost of a smile or a cheerful greeting to a fellow co-worker? Why do some people find it difficult even to open up on a psychiatrist's couch? The Mask The most common reason for Mr. or Ms. Grumpy is that they have probably been emotionally brutalized in their formative years by an authoritative parent and this has caused them to lock themselves up double quick in a shell and throw away the key. Now, that can be tough and extremely painful. It is a prison of their own making through which nobody can see that once bright-n-chirpy personality frozen, much like the curse of the wicked witch in those fairy tales we read. The person is dying to let his emotions out and let people see who he is, but since very little light escapes out due to the tough mask and veneer, that it is an uphill task. Then the sheer anger at not being understood, subconsciously plays havoc and then he gets to be the more demanding boss at work or that sullen wife or lone stranger staring in to nothingness on the park bench. These are the people that have a series of relationship disasters as their defence mechanisms are too solid to be penetrated. Some people may be naturally distant, and for them the finer and higher emotions probably don't register as much as they do in the average person. These guys are cut out for careers ranging from lighthouse keepers to morgue attendants to hangmen, where being emotional has no place. There are still others who swing the other extreme by showing so much of emotion that it is scary for others to take them on. Their emotional side is so overwhelming and demanding that it is actually a clever subterfuge on their part to drive people away as they subconsciously do not want people to get to know their real side. They generally don a mask of humor and good cheer and are great fun to be with. In reality, they are alone and scared and perhaps hurt emotionally. So, they feel safe to display emotions to masses rather than individuals. These people make good evangelists and rock stars as they can safely display and get an emotional discharge without running the risk of a one-on-one emotional exchange where they are afraid they would be hurt. If you encounter such a person who looks askance at you displaying your emotions, then it is better for you to talk things out and maybe put things in perspective. Of course, this all depends on whether you are emotional enough to maybe give someone a chance by understanding what drives them to do the things they do. Let me assure you the ice will thaw if the intention is genuine and well meant.
Faking illnesses - An illness in itself?In 2008, a 28 years old woman in the US shared some shocking news with her friends. She had been detected with cancer. She posted updates on social networking sites and wrote blogs on her illness. Sympathy poured in from all corners. Some even sent in monetary help to cover her expenses. The saddest part of the incident though was not her cancer; it was the fact that she had faked it! Police investigations revealed her little trick when no evidences or records were found at the hospitals! Apparently, this isn't a unique case;  faking illnesses or malingering is a very common occurrence. All of us have done it at some point in our lives. While we may have done it to escape a school punishment or to take undue advantage of the office 'sick leaves' for personal purposes, it is usually done on a harmless level. But faking illness can be a chronic disorder too and  medical professionals even have a name for it-; Munchausen's Syndrome. People suffering from this syndrome fake illnesses that they don't actually have, to gain sympathy or simply to be the center of attention. Usually gaining sympathy is the main reason why people fake illnesses. It gives them a chance to be in the spotlight. Everyone calls and visits, expresses concern and fusses over them. Lots of love is showered upon them. Another common reason for faking illnesses, is money and at times, the monetary benefits are higher than the emotional ones. No one hesitates to fulfill the last wish of a dying person, however expensive it may be. Often there are mixed motivations and the person faking an illness has many reasons to keep up the pretense of being sick, for as long as possible. Some people really do have a disease — a mental illness known as a factitious disorder. People with this disorder pretend to have an illness, which is usually a terminal one and often go to great lengths to maintain their hoax. Munchausen syndrome by proxy, is another form of faking illness. People with this disorder, fake illnesses of people under their care; and they usually do this, for monetary benefits. Children are the most common victims in this disease. When you tell someone that your child has cancer, you will receive a great amount of sympathy and all the money you want, no questions asked! People with these disorders are extremely cunning. They go to great extents to maintain their lies. They will build grand stories, complain of fake pains and aches, get admitted to hospitals and undergo a battery of tests, numerous times. Interestingly, they never allow and frequently discourage medical professionals, from talking to any of their family members. Since they know they are faking the illness, they will refuse to undergo treatment, for obvious reasons. . If you think a loved one may be exaggerating or faking their health issues, attempt a gentle conversation, voicing your concerns. Avoid anger, judgment or confrontation, while offering support and care and if possible, help them in finding a treatment. Treatment includes empathy, helping in identifying feelings and issues that led to the development of the disorder and finding  alternative healthy ways to deal with those feelings and issues.
Beating the weight loss plateauThere comes a stage when you stop losing any weight in spite of strict exercise and diet regimen. This is called as weight loss plateau. When calorie intake is reduced along with exercise, the energy required is obtained from stored fat which eventually leads to weight loss. This rate of weight loss slows down and eventually stops once body reaches its set point of metabolism. This set point varies from person to person. So what can you do next? Here are some easy ways to get the weighing scale budging: Modify diet pattern: Metabolism slows down with lowering calorie intake. To reset metabolism, you need to have an adequate amount of calories. This can be done by including fruits and vegetables, whole grains, and proteins in diet. More energy is needed to burn proteins than carbohydrates or fats. Eat within half an hour or hour after exercising. Add proteins and carbohydrates to diet. Sip water: Increase total water intake in a day. Drink water before, during and after exercise and throughout the day. Change the workout: Change the exercises you do daily. Muscles get accustomed to a routine workout. Switching exercises and continually challenging helps burn more fat and build lean tissue. Change the type and time or duration of exercise. Try cycling instead of running if you have been doing it for long. Running, swimming, dancing, and Pilates too are good options. Skipping and brisk walking help in burning calories too and break the plateau. In the gym, change the exercise or number of repetitions. If you have been working on machines for long, try weight training or floor exercises. Take rest: Adequate rest is essential for the body to rejuvenate. Muscles, tendons, and ligaments get slight internal and external injuries which can be healed by rest. Proper rest helps repair and regenerate the tissue and makes them strong. Make these changes and get the needle on that weighing scale to budge.
Sleep tight at every good night!A good night's sleep! Oh, what would some of us give for that luxury! Sure, you can blame it on the fast paced world and the things you have to do to keep the competition off your turf, and millions of other reasons to be sleep deprived. Yes, sleeping soundly and regularly is well within our control. Maybe it has eluded you so far and you are caught in a vicious circle of staring at the ceiling for hours on end; so read on to see what simple things you can do to gently drift off in to the arms of nature's greatest restorative- beauty sleep. Do's and don'ts for beauty sleep Fix a regular bed time, so that your brain will adjust to this by sending sleep signals to the body. If your bedtime is completely at the mercy of your activities then even as fatigue sets in the body will refuse to obey. So, even as your body is screaming for rest, the mind does otherwise. This is where good old discipline comes in to play. Take in to consideration the activities which are absolutely necessary to do and note the frequency with which they are likely to interfere with your bedtime before setting a realistic bed time. Initially the mind will refuse to obey, and you are most likely to get up, after tossing and turning in bed, to switch on the computer or whatever it is that you do when you cheat your bedtime. Rest assured, in a couple of days the brain will get used to this sleep routine and prepare you for shut down. Sleeping well also largely depends on how stress free you are. If the mind is in a state of constant excitement or anxiety, sleep will elude you. So when you lie down to sleep you need to fade out and blank everything out- joy and sorrow; expectations and ambitions, all of these out for later access! Tell yourself that tomorrow is another day and what you need today, is a state of neutrality! That's what most Indian philosophers would want you to do anyway. A good eight hours of sleep may depend largely on our minds but external factors can matter too. Sleep comes easily when your mattress is comfortable and not too soft or too hard. Use a pillow that won't give you neck pain, as any discomfort in the neck is likely to throw sleep off gear. Wearing clean night clothes can give you better quality of sleep. That goes for the bed spread as well.  Try this for yourself. Tight and uncomfortable night clothing is not recommended as this will only make you wriggle about for comfort. A cozy blanket and some clean nightclothes make great bedtime mates. Some people have a nightcap to help them sleep better while others still, drink themselves to sleep. Alcohol in large doses can only numb but does not help you sleep and you will only find yourself waking up frequently. Sleeping pills can be habit forming and might have serious side effects in the long run. So try simple remedies like a glass of warm milk or hot chocolate before bedtime to help you sleep better. Avoid stimulants like coffee, tea or nicotine before bedtime as that can keep your nerves all hyper thus making sleep quite difficult to come by. Computers and television are also largely responsible for us staying up late and disrupting our sleep patterns. We often find ourselves mechanically flipping channels or browsing without any real need for it. Try and go offline before bedtime, especially if you want to be able to schedule your sleep time. Television or movies can excite the brain and then you will find it difficult to fall asleep. So about an hour before bedtime switch off the telly or computer and just sit quietly and do some deep breathing exercises. Just sit cross legged for about ten minutes and relax your body. You are now ready for a deep slumber.
MigraineA Severely painful persistent headache can put anyone in distress. Migraine symptoms vary from person to person. Some people get intimation before the pain begins. It can be sparkling flashes of light, blind spots, or distortions. Some others experience tingling or "pins-and-needles" sensation in hands or face. This is called an aura. The headache begins within 30 minutes of seeing an aura and may last for 4 to 72 hours. Extreme sensitivity to light, noise, smells, nausea and vomiting, loss of appetite and fatigue, numbness, tingling, or weakness are all-common in migraine. There is no permanent solution to migraines. People suffer for years together and keep on taking painkillers for a long time. Pain killer helps only if taken right at the beginning of the headache. Keep a watch on things that trigger the migraine and try to avoid them. Make some lifestyle changes that can help prevent migraines to some extent. Taking good sleep. Lack of sleep can cause migraine. Appropriate hours of sleep as a routine will help to prevent the attacks. Regular meals at fixed time help to prevent migraines in people who get headaches due to hunger or not eating on time. Regular exercises help to rejuvenate the body and prevent migraines along with many other diseases. Stress is another important cause for migraines. Avoid stress. Learning to manage it will keep migraine at bay. Caffeine triggers migraine in many. Avoid caffeine. Reduce it if quitting is not possible. Limiting alcohol will again be very beneficial as alcohol and hangovers can be the cause. Meditation and relaxation therapies may also help prevent migraine headaches.  
A primer on heart attacksIndians around the world have one of the highest rates of heart diseases. Heart attack, also called as myocardial infarction, is mainly caused by a blockage that prevents oxygen-rich blood supply to your heart muscle. In other words, it is the death of the heart muscle. What causes a heart attack? When cholesterol deposition, plaques of calcium and proteins on the walls of your coronary artery cause blockage of the artery, your heart fails to receive sufficient nutrient-rich blood. This leads to the permanent death of heart muscle, and it is unable to pump the blood to your vital organs. Symptoms that signal a heart attack   Chest pain is a symptom of a heart attack.  This pain can feel like tight ache, pressure on the heart as if an elephant is sitting across the chest. However, you may get confused with the symptom chest pain - whether it is a heart attack or an angina pain. Chest pain lasts for a longer time in heart attack whereas the chest pain in angina lasts for few seconds and goes away after rest. The pain experienced during a heart attack sometimes feels like indigestion or heart burn. Other warning signs of heart attack are: Shortness of breath. Lightheadedness or fainting. Upper body discomfort in arm, the back, neck, and jaw. Nausea, vomiting, dizziness. Sleep problems or fatigue. Not every person will have the same symptoms of the heart attack. But if you have any of these warning signs, you have to act fast and get the right treatment.
Work woes - The sexual problems of busy peopleThat one day Mr. X took half a day off and sneaked into his house to surprise his wife, he found her not tending to the garden, but attending to Mr.XXX, the neighbor! Long after the echoes of the shotgun had died down and way after Mr. XXX hopped off, holding on to dear life with trousers around his ankles, Mr. X was found asking himself loudly - why me? Though this story does bring about some amusement, it really isn't amusing to know a whole lot of relationships just going bust all because of the sex word and deed. Couples today are busier than ever, and after the initial euphoria of the relationship wears off; work, career advancements, salary packages get more precedence. Relationships start going off into the realm of a comfort zone where physical touch, intimacy, and sex take a back seat as most people think - "there will be a lot of time for that later." However, time and tide wait for no one- not even bright career enthusiasts, who put their careers over their relationships, only to wake up one day to see their love gone wrong! This is not to say that careers and hefty pay packages and promotions are not important. After all, we can rightly hear one say, "One cannot survive by love and fresh air alone." However, just as it is compulsory to swipe your card at the office door, couples have to ensure that they save some swiping for the bedroom as well. Easier said than done? Perhaps! Here are some of the typical problems that plague the love life of busy people : We have a relationship, why do we need sex? That may be just one partner's opinion! A man who thinks for two and loves for two is going to be in for a nasty surprise at some point. Sure, work pressure will always be there and so will conference calls and decision making. So, if you think your partner is going to live by the memories of your last intimate encounter, you need to get a reality check. Sure, your partner will probably understand that you are busy and maybe the fault is not entirely yours- maybe she is busy too! Sooner or later, you will have to figure out whether you are just flat mates or a real couple. And a real couple does things together- laughs, meets, makes love, fights, makes up, and all that! A good sex life only reinforces the emotional bond between couples and takes the relationship to another level. Going purely by sexual intercourse, then yes, sexual intercourse is, of course, healthy and has a lot of physiological benefits to offer like reduction of pain and feel-good endorphins. Some of us might just take only that bit and have sex with the first available person in sight! The point is sex within the framework of a relationship, can give better results and can foster strong ties, but the guilt from cheating on your partner can also add another reason for stress, which considering your already busy life, could well be the final straw that broke the camel's back. We do have an annual vacation, don't we? Sure! Timeshare holidays and stock options can make the best of vacation places easily accessible. So, the deal is - take your annual vacation abroad and stop groaning! What if you were paid just once a year or were allowed to eat just once a week? Would make you feel really great, right? Relationships need more than your annual vacation. Even a regular walk in the morning together is a better idea than a vacation on a cruise liner. In our material aspirations, we forget that good things in life are completely free. If only you weren't so brand conscious, you would've seen them right away. So, don't save all that sex up for the annual vacation; a weekend getaway will, in fact, add more spunk to your life. Thinking of you! Even the thought that one is in someone's thoughts can be so warm and bring out the best in a person. People who have a partner waving them off when they set off to work are generally happy and more productive at the workplace and have fewer disagreements or upsets. So, imagine the good luck charm being quadrupled by lovemaking! Call it stolen moments of passion. Take a chance... you might just be a little late for work, but then this is important business too! Be spontaneous and watch your partner respond to your sense of urgency. If that's not possible, then at least send a "thinking of you" message, or if you are more creative, you can personalize it with your brand of naughtiness and raunchiness. Rest assured, this will help you actually find the time to make love on a regular basis and your girl might even find a new you and actually miss you when you are gone. Shift workers: Don't shift the blame...shift the time to make love. The tragedy of these times is when both people are out working and both are extremely ambitious and both work different shifts. He is dead tired when she is all up and chirpy. It is night for one, daytime for the other! Wow, what a predicament to be in! One weary soul bone tired and hardly in the mood for love making! Who says you have to go all the way every day. Even touch therapy can be extremely enchanting, healing, invigorating, and can eventually lead to sex. Imagine a hand that caresses your brow as you crib about your boss's bitchiness or the conference that you have been given single handedly to handle? A kiss exchanged at the right time can sometimes do way with the sex part if you are too tired for it. Important thing is to wake up in your lover's arms rather than wake up too late to the fact that you have no love life. This can be a beautiful experience and you can exchange places, giving your partner a sensual body massage when she comes back from her shift. Making love, for sure, is important, but what is more important is keeping the love alive for the making of it!
Reasons for skipping sexThe most important satisfaction brick in a marriage's foundation, sex is where we show the greatest trust, most openly express intimacy and make ourselves most vulnerable. It is the most personal and private area of our relationship. It is the one area that separates this relationship from all others. Yet, there are times for both husbands and wives when sex becomes a burden and not a blessing, an inconvenience instead of intimacy, and a job instead of jubilee. Curious as to why people might be skipping sex? This is only a partial list and far from exhaustive. Reasons related to your body: I have a migraine. I have a stomachache. My body is too tired. My breasts are too sore. I am too sleepy. I can't keep my eyes open. I just need to take a little nap first. Okay, but I have a rash. Okay, but I have several weird looking cold sores. Reasons related to your emotions: I am depressed. I am worried. I am sad. Cry Reasons related to your kids: The kids are still up. We might wake up the kids. I just had a baby. This baby is wearing me out. Reasons related to your experts: My therapist said I need to give myself some time. My counselor said I should create some boundaries. I have to see my Gynecologist tomorrow. The Doctor gave me these sleeping pills for stress and I just took one. Reasons related to your spouse: Who was that girl / guy you were talking to on the phone? Sex, Sex, Sex All you ever want is sex! Why can't you just hold me? You should have asked in a more romantic way! Why do you have to use such crude language? Reasons related to your weather: It's just too hot. It's just too cold. It's too humid. Reasons related to your economy: When the economy improves. When the interest rates go down. When inflation goes down Reasons related to your special circumstances: We just got back from vacation! When I lose 20 kgs. Reasons related to your friends: I need to make a call first. My friend said they only do it once a month. Reasons related to your pets: The dog can see us. The cat is on the bed. Reasons related to your finances: Okay, but first we need to talk about the bills. Why did you charge this hotel room on our credit card? Reasons related to your job or boss: I have to get up early tomorrow. I was up all night last night. I had a long day at work today. The boss just gave me a new project and I have a lot of work to do Reasons related to your religion: Doesn't the Bible warn against having too much sex. I am sorry, but I just took a vow. I am giving up sex for Lent. Reasons related to your in-laws: We are in your parent's house. I have not been able to concentrate since your mother Your parents will hear us. Offer an alternative: Can I just take care of you in the shower? Okay, but you have to drive the kids to school in the morning. Use evasive tactics: Sneak in and go to sleep early. Okay, but let's watch this movie first. It's just too late. I'll be there in a minute. (Take an hour) Can we just cuddle? I just need you to hold me. Ask a sensitive question: Did you go to the bank and make our deposit today? Have you seen the kid's report cards? Wait for your spouse to tease you and then say coldly, well, you just lost whatever you were going to get tonight.
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