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Career advice for menGetting a job these days is extremely difficult. What is even more difficult is sticking around long enough at the job. No one is indispensable, and if you don't perform well, there are hundreds more waiting to get the job! Being the bread winner, men have to face this pressure more. Here are some tips that would do you good, if followed: Cracking The Interview: The golden rule here is to be honest. The interviewers do not want to hear what will please them; So, do not try to butter them up. They are also put off by boasting . Therefore, be honest about your views and opinions. Age:wise Attitude- When you are young, and have just entered the company, it is highly advisable to observe and learn as much as you can. Find yourself a professional mentor who can guide you. Try and build on your professional presence. Be active, spend more time with your boss, be helpful to your juniors. The golden advice for all, irrespective of seniority, is to stay clear of office gossip and politics. Keep a check on the attitude: There is no need to be arrogant, and a know-it-all. Be friendly, confident, and genuine. Learn to say no: You need to have a pleasing personality. But, avoid trying to please all. Try and learn the art of saying no firmly. Too much of 'yes' will make people take you for granted, and you will find yourself overloaded with a lot of work. Do not under price yourself: If you feel that you deserve a raise, go ahead and ask for it. Do not be afraid to ask for your worth. Often at interviews, employers cancel out candidates who under price themselves, as it shows that they will probably not perform to the expected levels. Blow your trumpet: With all humility make sure you take what is rightfully yours. If you don't take credit for the work, no one will give it to you. Worse, someone else may take it! Create boundaries: Keep your work at office. Do not bring work home. Often at the outset, to please bosses, one ends up working overtime or worse, working at home. It is important to keep both the parts of your lives separate. Keep fit too: Don't let your job take a toll on your health. Working late, sitting at the same place for hours, can be harmful for the heart. Learn to unwind periodically. Setting goals is easy. What is needed is the determination to follow the rules you have set for yourself. The way to success at work is taking the ladder, one step at a time. There is no elevator here.
Menopause and mental health!Menopause is the period in a woman's life when her man claims she is going crazy. It is also the time when her period is on the decline and hormones are in complete disarray. Depression, insomnia, irritability, mood swings and lack of concentration are few symptoms that the lady has to battle with. These symptoms may begin as early as 4 years before the actual menopause and may continue for several years after that! For women, menopause is a significant turning point in their lives. The dropping levels of oestrogen and the resultant physical and mental symptoms can be like a cycle of events, only adding to their woes! Depression: Depression affects every middle-aged woman. An estimated 20% of women have depression at some point during menopause. The peak period for depression is during the perimenopausal years, when the woman is approaching menopause. The reason for this, say experts, is the fact that most women dread menopause. Even though for some it means an end to years of menstrual cramps, for most others it signifies an end to their womanhood. The very idea is sufficient enough to bring on lots of negative thoughts and depression. Not only this, the reason for depression during perimenopausal and menopausal age is the fluctuating hormones. Research shows that the levels of reproductive hormones, specifically oestrogen are responsible for the mental changes. Changes in the sleep pattern: Insomnia is seen in 40 to 50% of women in the menopausal transition phase. Women who spend sleepless nights are more likely than others to show irritability, crankiness, stress and depressive symptoms. Sleep disturbances during menopause have been linked to the decreasing oestrogen levels. Indeed this claim can be held true as several women respond positively to exogenous hormone therapy. One study claims that sleep changes are linked to the Luteinizing Hormone levels, which also results in increased body temperature. Sleep apnea too occurs in the menopausal transition age. This is due to decreased progesterone level, as progesterone plays an important role in respiration. The weight gain that happens during menopause has also been shown to cause sleep apnea. Panic disorder: Panic disorder is commonly seen during the perimenopause stage. Existing disorder may worsen or new disorder may arise. Panic disorder is usually manifested in women who show several physical symptoms of menopause. The panic attacks are usually associated with negative life events, pre-existing medical diseases and decreased daily functionality. Obsessive compulsive disorder: New onset of OCD, worsening of the existing condition or change in the pattern of symptoms is seen during menopause. OCD changes are also observed during pregnancy and during the menstrual changes, suggesting the impact of hormones on symptoms of OCD. Bipolar disorder: Women with bipolar disorder experience an exacerbation of symptoms during the perimenopausal stage. These women are also the ones that are highly likely to experience severe depression in the menopausal phase. Schizophrenia: Schizophrenia usually manifests itself in young adulthood. The rate of new cases decreases gradually thereafter, in both men and women. In women, however, there is a second peak in the 45-50 years age group. This peak is not observed in men. This suggests that oestrogen may play a significant role in triggering schizophrenia or worsening the pre-existing condition.
Fitness mantras during pregnancyYou must be wondering how Shilpa Shetty maintained her fitness even after bearing a child. The simple answer is that she never gave up exercising. Exercising during and after pregnancy is the best way to stay in shape and ensure your mental and physical healthiness. It also helps you in preparing for labour pain and delivery, and quick recovery postpartum. However, there are some things you need to keep in mind while exercising during pregnancy: Measure your fitness You need to determine how fit you are. This will help in determining the type and duration of exercising during pregnancy and post pregnancy. Also, before you continue your old exercise routine or begin a new one, you should talk to your doctor about exercising while you're pregnant. Pregnancy is a balancing act After the fourth month of pregnancy, it's likely you will lose balance while you exercise. Though your baby is well protected with amniotic sac, it is better to be safe than sorry. Safe exercises Activities such as swimming, walking, yoga, pilates, and low-impact aerobics are good choices. Pregnancy is not the right time to start any new intensive exercise, but it is safe to continue with most types of exercise if you're used to them. The things you should avoid Avoid exercises where you are likely to lose your balance or could make you fall or slip. Vigorous or extreme activities such as horse riding, skiing, mountain climbing are out of the question. They carry too high a risk of injury to your tummy. Avoid exercises such as: Sit-ups Standing on one leg Separating your legs widely You should also avoid most contact sports, such as football, basketball and so on. Finally, give racket sports a miss if you're not a regular player as they can be tough on your knees and ankles. Check with your doctor Consult the doctor before starting with any new or unusual exercise. Check for any complications or unusual conditions. Also, discuss for any concern such as: Pregnancy-induced high blood pressure Early contractions Vaginal bleeding Premature rupture of your membranes, also known as waters (the fluid in the amniotic sac around the fetus) breaking early The best outfit for exercise Clothes should be comfortable and loose fitting while exercising. Wear a supportive bra which protects the breasts and is also relaxing. If your shoe size has changed because of mild swelling, you may want to buy a new one. Duration of the exercise Exercising three to four times a week is necessary. This reduces stress, fights fatigue, and stabilizes emotions in early pregnancy. Start gradually, may be with only five minutes a day, if you were totally inactive before. Add five minutes each day till you reach 30 minutes. Also keep in mind to avoid exercise on an empty stomach. Eat a snack 30 minutes before exercise. Never over do Listen to your body when it says 'stop'. Over exercising causes overheating. Raising your core temperature too much can affect the baby adversely. Always sip water before, during and after exercising. Listening to your body when something hurts or doesn't feel right - that means stop. Drink a lot of water Try to drink about two glasses of water two hours before you begin exercising. Take a sports bottle of water with you when you exercise and take frequent sips from it. It's important you don't get dehydrated. This may raise your body temperature, which may not be good for you or your baby.  Keeping these points in mind, exercise to stay healthy and fit. We hope you soon give birth to a healthy kid.  
Teenage troubles for autistic kidsTeenage brings along with it a lot of physical and psychological problems. Your body undergoes a lot of changes, the way the world looks at you is changing and you are not in the position to accept all this. Teenage is one of the most painful periods in one's life.  For an autistic child teenage can be compared to living a nightmare day in and day out. Here is a look at the problems of teenage from an autistic kid's point of view: Social Interaction The ability to interact socially is absent in autistic kids. They are loners who prefer to be left alone and undisturbed in their own worlds. Such a child is a natural target for bullying and ragging by other kids of his age group. At times even if the autistic child wants to come out and make friends, he is not able to do so due to lack of the required skills. Teenage is a period where you need at least one friend to confide in. It can be an extremely difficult phase when you are all alone. Puberty This is the dramatic time in life dilled with hormones and emotions. Your body undergoes lots of changes and you are confused about so many things. You don't know whom to ask or whom to turn to for guidance. Autistic children do not have the maturity to understand this phase. Special issues for autistic teens and sexuality include: Knowledge of physical changes in body. Knowledge of 'good' and 'bad' touch. Ability to communicate about a 'bad' touch or action. Keeping 'safe' distance from others. Handling menstrual cycles. Avoiding 'self-touch' in public. It can be a phase of emotional turmoil for the parents. They need to work closely with their child's special teachers to chalk out a plan that will be best suited to the child in handling puberty successfully. Self-help skills Simple self-help skills like hygiene can be a challenge for teenagers with autism. Improper motor skills, compliance, and sensory problems may interfere with a teen's progress. The proper training of hygiene and grooming can help to add these elements into the daily routine. The right approach is to simplify each task into simple small steps. The positive reward system is a great source of encouragement, as positive motivation always help the teenagers. Higher Functions Autistic teenagers are socially awkward. They lack the power to comprehend and process complex social cues which includes sarcasm, body language, humor, emotional responses and facial expressions. What complicates the problem is that the autistic child lacks empathy and hence may appear rude. Such kids are likely to be teased a lot in school settings.
How to remember everyone you meet?Now that would be quite a feat, would it not? To be able to recall the name and occupation of every person we ever encountered right down to the minutiae of how, where, and why we were introduced to them to begin with! Sometimes we raise the bar of forgetfulness to the extent of forgetting just who it was who introduced us to "Mr. what's-his-face!" If only there were ways to remember the modest and average people who leave virtually no impression on us, wouldn't that save us great embarrassment? Plus it will help us do away with those sheepish looks when it dawns upon the other person that you haven't the foggiest of notions as to who he is. Stranger: Hi! You remember me? How are you doing, Frankie? Frank: Umm! I am well (this guy's face looks mighty familiar, but for the life of me, I cannot recall ever having cast my eyes on him). Stranger: So, how was your annual bridge completion? Manage to beat the Swiss pairs this time? Frank: Atta boy! Got it! This guy happened to be kibitzing at the weekend bridge club at Aldermere. Whew! Stranger: You gave me quite a start there. You looked right through me and I was quite not pleased at the fact that just last week I happened to congratulate you. Frank: Well Martin, be tough to not remember you, of course I do! Just didn't think of bumping into you here. Martin: Well, I am Walther and I can now see that you don't remember me at all! How many times has the above scenario happened to us? While it is well-nigh impossible to remember every name or face that we come across, it would be  a good habit to at least attempt our 'mental name book' to avoid an occasion for future embarrassment! Now, how in the world does one do that? Simplest way would be to carry a small notebook with a pen to make note of someone that you have just been introduced to, at a meeting or a social do. Our friends often introduce us to people and chances are that if there is no occasion to remember that person, then the brain fades it out of its memory list, as it will only use up space on the brain's 'hard disk.' Human memory might be jogged to remember trivia from 25 years ago in great detail, but ask a simple question - remember what you had for lunch last Tuesday?  - and that would be very difficult to answer, especially if last Tuesday was just an ordinary day with no special reference points around lunchtime to help you remember. Maybe if something momentous had occurred on Tuesday last, like pretty Meg from next door, sharing lunch with you rather unexpectedly, then you can bet your bottom dollar you will remember what you had on the day in question. So create reference points! When you are introduced to someone, first and foremost, reference it with who introduced you and then try and make a reference of at least one unique distinguishing feature in that person. Now you don't really require the eye of a physiognomist, and it would be mighty impolite to stare hard for the "distinguishing feature" coin to drop. So a quick look and you got 'long nose Mary Gomez' all referenced and ready for recall at the next chance meeting. Make the reference phrases funny so that you won't have any problem whatsoever in recalling the name behind the funny phrase when you most require it. Alternatively, try associating a picture with the name if you aren't very good with phrase reminders. These techniques are called mnemonics, which is pronounced ni-mon-nics, and funnily enough the very curious spelling - Mnemonics makes you want to have a picture card memory association for the right pronunciation. A mnemonic for this could be 'knee-moan- knicks". Easy enough, i.e., if you remember the sequence right. You could also try memory exercises with names picked off from the telephone directory at random. Pick an A-lister say - 'Anderson' and then flick through to D and pick 'Dougherty' and so on until you have picked at least 10 names of a different alphabet. Now, try and write down the numbers that you must have undoubtedly memorized until now. You can consider yourself blessed even if you are able to memorize the number of the third person by the time you reach person number 10. This will give you a memory for names and numbers at least. Or, go through any university web sites and look at the photo galleries of past alumni. Give yourself 1 minute to quickly glance at all the names on the page. Then try and recall the name by applying the memory picture association or develop your own technique. With regular practice, you could well be in the employ of the local police to help identify criminals off a line up. If that's too dangerous for you, then at least that will  keep your brain alert and active with this brain gym and help avoid any boo-boos in the future.
5 cardinal sins for the skinWhile cigarettes may not constitute food in the strictest sense, it does have a profound effect on skin complexion, health, color and tone. We eat that we may live, but sometimes we eat way too much and consume stuff that may be extremely hazardous to our health. Since we are talking about skin, here are 5 most hazardous foods for your skin: Grease adds to the crease Since healthy skin is all about healthy blood circulation, any food which is likely to clog up the blood vessels internally is deemed bad for skin tone. Packaged snacks like potato chips may have edible oil written in bold but this contributes significantly to the slowing down of 'collagen and elastin syntheses' which in turn causes the skin to appear aged and all wrinkly. The french fries that we consume as a TV snack can also cause an acne outbreak on the skin and face. Gluten Glutton Gluten is a substance found in wheat and other food grains. We may not even be aware that some of the food grains have gluten as a main constituent. Gluten intolerance can also cause inflammations on the skin in the form of rashes or acne. Bad news is that the pizzas, pastas, cakes and bread that we get off the rack may be heavy in gluten (Surprised that they don't say that on the pack) and that may be the reason for you to lose precious skin tone. So seek gluten free foods, though that might not be the easiest of tasks, but for your skin, it certainly will be worth it. Caffeine - the skin coffin If you are one of those coffee addicts then you may as well write an obituary column lamenting the loss of your skin tone and complexion. It's not without reason that health freaks love bashing coffee beans and caffeine rich beverages, as they are truly hazardous. How? Studies have proven that just 2-3 cups stimulate pituitary-adrenocortical response. Yes, but what does that have to do with your skin? Well this leads to the hormone cortisol to increase in our bodies. Cortisol is known as the stress hormone! So now here's what it does to your skin -it accelerates the ageing process which means wrinkled skin and causes dehydration causing the skin to show an unusual pallor. So before you turn the coffee faucet on think twice. Fad to Black How fad diets are not skin friendly? Some people go on a high protein, low-carb diet which could sound the death knell as far as complexion goes. Dieting depletes calcium levels, which means your bones are going to suffer and what's the point of having skin on bad bone density? Besides low-carb diets can utterly wreck the complexion as the delicate PH balance in the skin is ruined. Some of the meat, poultry and dairy products too can have artificial chemicals injected in them which cause a hormonal imbalance in our bodies leading to skin disasters. Fruits and vegetables have chemicals injected too sometimes! Beware! Cereal Killers Cereal killers are those people who ignore the need of a proper diet for skin health. So anybody who indulges in too much sugar, caffeine and greasy food stuffs is a 'Cereal Killer' A lack of cereals in the diet can literally kill your skin. Cereal foods have high fiber and antioxidants for moisturizing the skin and protecting it from skin damage. For great skin other than cereals which are simply fabulous for keeping skin hydrated and breathing easily, one can eat fruits, olive oil, healthy fats, almonds, tofu, grains, nuts and the good old vitamin B rich products. Ceramides in raw food diets, organic foods, wheat germ and brown rice protect the epidermis of the skin and make it impervious to external attacks and pollutants while maintaining their tone and beauty.
Exercise, a healthy way to deal with hypertensionYou have not exercised for a long time. You took it easy when it came to physical activity. Now that you are diagnosed with high blood pressure, you will do anything to control it. Even exercise! Exercise, weight management, and a healthy diet are important ways to help prevent high blood pressure and lower the blood pressure that is already high. Benefits of exercise for people with hypertension include: Improve blood and oxygen circulation in the body Promotes sound sleep Improves stamina and endurance Keeps heart healthy Reduces stress and promotes mental health Exercise enhances the effectiveness of medication So how much should one exercise? An exercise session of atleast 30 minutes per day is important. Get started Start slowly and increase gradually. Start with 10 to 15 minutes of exercise and increase it, as youget comfortable. Choose exercises you enjoy and will do consistently. Avoid sudden vigorous activities; they can cause injuries and hamper the routine. Warm up Warming up helps the body adjust slowly from rest to exercise. A warm-up will reduce stress on the body muscles, increase heart rate and respiratory rate, and body temperature slowly. It will also decrease soreness of muscles. Best exercises for lowering blood pressure Stretching: It is the best. It relaxes and helps prepare the body and muscles for activity and prevents injury and muscle strain. Stretching regularly will make you flexible and improve motility. Aerobic exercise: This helps to improve circulation to the entire body. It improves heart function. It gives maximum benefits to the heart. They also help to reduce heart rate and blood pressure by improving breathing pattern thus lowering blood pressure. Walking, swimming, jogging, and skipping are all aerobic activities. Do aerobics for at least 30 minutes three times a week. Strengthening exercises: These include exercises that have repeated muscle contractions till the muscles are tired. These include side balance crunch, climbing a rope, and push-ups. Join a gym. Here are some  exercise guidelines for a better exercising routine in the gym:  Schedule a fixed time for exercise. Find a buddy to exercise with you. Select an exercise that you like. Make variations to avoid getting bored. Boredom can make you stop exercising. Start slowly and increase gradually, especially if you do not exercise regularly. You should wait for an hour after eating before you exercise. Ten minutes of warm up and ten minutes of cool down sessions are must Keep a record of daily exercise.
Common causes of allergic reactionsAllergic reactions, most of the times, do not warrant immediate medical attention. But never ignore or take any allergic reaction lightly! Allergic reactions include itching or a puffy face or swollen red blotches all over your body or a fit of sneezing.  If we know what allergies have, we can avoid the triggers. So, here is a list Soaps and detergents: Are your palms are all rough and peeling off in patches and it doesn't seem to go away? Time to do a check on the dish-washing soaps and the detergents you may be using. Most of the brands contain harsh chemicals that burn while you use them. Medically known as Contact Allergic Dermatitis, this is one of the most common allergic reactions. Artificial Jewellery: Even the best looking jewellery can, at times, trigger allergic reactions. Another common type of Contact Allergic Dermatitis, this happens when you wear artificial jewellery. Most of the jewellery of this variety contains Nickel which is the main cause for this type of allergic reaction. Clothes: Clothes can be a cause for allergic reaction. While synthetic fibres like nylon and polyester are common factors, at times, the chemicals used in the dyeing can also be a reason for allergy. Add to it the perspiration and the constant friction between the skin and the clothes, and you have a severe allergic reaction guaranteed! Latex: Latex is also a very common cause for allergy. Commonly found in condoms, gloves and certain medical devices, allergy to latex can range from minor itching and redness, to a serious life-threatening anaphylactic reaction. Milk and milk products: The symptoms for this source of allergy include loose motions and stomach, among other things. Medically called as Lactose intolerance, it occurs in people who do not have the necessary enzymes in their bodies to digest milk and milk products. Food allergies: Peanuts, brinjal, fish etc can also trigger allergic reactions. Food reactions are specific to individuals. One may suffer from an allergic reaction to almost any kind of foodstuff. Beauty products: From shampoos and creams to nail paints and lipsticks, every cosmetic you use is a potential allergic trigger. Molds: These are microscopic fungi found in damp and moist places.. Allergic reactions to molds are pretty common and seasonal. Cockroach: The proteins secreted by the glands and the saliva of the cockroach can be allergic to humans. Sneezing, itchy and watery eyes are common symptoms. Insects: Insect stings can lead to burning and stinging pain with redness and a slight swelling around the bite/sting area. In some people though, insect bite/sting proves to be life threatening. Symptoms as severe as difficult breathing, rapid pulse, severe drop in blood pressure and swelling of face and throat may occur!
How to talk about STDsThese are dangerous times that we live in. Just the sheer number of people affected by sex related problems, diseases and conditions all over the world is simply terrifying. AIDS, venereal infections like syphilis and gonorrhea, herpes, HPV etc. are rampant and it calls for some responsible sexual behavior. However, that's a utopian world where humans will be monogamous and will behave responsibly. Even single people might get exposed to these diseases through indulging in risky sexual contact. Imagine doling out $750,000, as a woman in the US got from her husband because he gave her herpes. Even if you are not held legally accountable, what about moral responsibility to own up and discuss a possible STD infection with your partner! Take the case of Jack a happily married man for ten years who had casual sex when out of town on an official trip. He showed no obvious symptoms of any infection but in a month, his wife showed signs of herpes and his marriage crumbled as his wife struggled to come to terms with her husband's obvious infidelity and his callous manner in exposing her to a serious sexual infection. Call it ignorance but sometimes a person might engage in sexual intercourse and contract a disease which he might even not be aware of until the symptoms start appearing. (Refer article on Syphilis on www.topdoctorsonline.com) By then, he might have, in all probability, passed it on to his regular sexual partner or spouse. Or perhaps, there is another possibility that the person knows that he has contracted a sexual infection but doesn't know how to break the news to his partner.  If a person is aware of his infection, yet exposes another person knowingly, it is akin to premeditated murder. Yes, it is going to be a difficult thing to tell your partner which might even signal the end of the relationship or cause severe strain on it. So, if you are caught in a situation like this, what would you do? The option would be to visit a sex therapist and confide in him and then take an appointment for both and let the professional break it to the partner. That is of course if you are in a stable relationship. For those who both party to casual sex, the infected person generally won't be that open about his infection and may even choose not to care particularly if the other person is a complete stranger. A report in MedlinePlus news reveals some more shocking statistics: Many people said they occasionally, rarely or never got tested before having sex with casual partners (50 percent) or long-term partners (39 percent). Of the people who did discuss STD testing, very few discussed concurrent sexual partners or when partners' testing occurred in relation to their last sex act. Only half explained what types of STDs their partner had been tested for. These issues are important components of assessing STD risk, the researchers said. About one-third of participants reported telling a partner they didn't have an STD even though they hadn't been tested since their last sexual partner. One U.S. woman was awarded $750,000 in court from her ex-husband because he gave her herpes, and the legal trend is to make people accountable. (http://www.dummies.com/how-to/content/how-to-talk-to-a-partner-about-stds.html) Remember even wearing a condom is not a 100% guarantee that the infection won't pass on to the other person but that's the least that you can do if you don't have the courage to spill the beans about your condition. If you feel that your partner may be indulging in sexual activity with multiple partners and if you feel he might be infected, then you are well within your rights to decline to have sex with him until he/she gets tested. If you notice sores around the genitals do not indulge in oral or anal sex or any kind of sex and insist on a condom always; it could save your life.
Painful intercourseSome of the causes affecting women can be: Going too fast, penetrating from an awkward position. Do not hesitate to tell your partner that it hurts and he needs to slow down or change position in order to make you comfortable and prevent pain. Dry vagina or lack of natural lubrication in the vagina. This dry vagina is caused due to some medications, changes at the menopause. Sometimes just increasing the time of foreplay can help vaginal lubrication. Use water-based lubricant to reduce pain. Failure to fire off. Sometimes failure of the vagina and uterus to respond to sexual arousal can lead to irritation and tenderness. The vagina may be too tight for the intercourse sometimes or the uterus may not be raised so that the penis comes in contact with the cervix during penetration. Using other penetration methods can be helpful to explore the level of arousal before engaging in intercourse. Vaginismus can be the cause of discomfort. Muscles surrounding vagina are sometimes very tight and lead to pain and intercourse to be painful. Woman can examine herself with her fingers to see if vaginal walls are tighter than normal. It can be vaginismus. Normal cause is nervousness or anxiety. It is reversible. Good foreplay before intercourse will help to relax the muscles and help lubricate. Just relaxing before the act can be helpful. Vaginal infection and inflammation due to yeast, herpes, etc. can make intercourse uncomfortable. Fabrics, creams, perfumes may cause irritation in area in some women. Avoid these. First-time sex can be a little painful. Rupture of the hymen can cause discomfort during penetration. Start slowly or begin with forms of penetration other than intercourse. Psychological pain. Sexually traumatic experiences or feelings of guilt associated with sex can make the act painful. Consult a sex therapist or psychiatrist. Discomfort during intercourse is experienced by men too, various causes affecting this outcome for men are: Tight foreskin. During first attempt at intercourse, tight foreskin will make retraction painful. After sometime, the foreskin will become loose and make intercourse comfortable. Any lesion on the penis skin can make intercourse painful. These may result from non-lubricated masturbation or rapid intercourse or STDs. The blisters due to herpes infection can make intercourse extremely painful.
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