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The moody man - Mood swings in menMen, such jokes on a woman's monthly mood swings are passe. Recent research proves that men are equally prone to have mood swings. Have you experienced a myriad of emotions? Angry, irritated, feeling helpless, self-pity, an irrational urge to throw things and cry and be depressed all at the same time? These are signs of mood swings. And the point of interest here is that you don't have to be a woman to experience mood swings. Men face their share of mood swings too! Men undergo hormonal influence too. And like women this causes them too to be irritable and cranky. The difference here is that the hormonal fluctuations are not as severe in men as in women. So the mood change lasts for a lesser time compared to a woman. Men's moods are also affected by psychological and physiological stressors. So a man who has to work against time to meet a deadline will be very irritable. A man who is deprived of sleep will end up snapping at you for no apparent reason. The myth that men don't cry, is something that men take to heart. Men are emotional beings and it is okay to show some of the emotions. The male stereotypical image is such that if a man is expressive of his emotional side, he isn't considered macho enough. Hence men tend to internalize their emotions and feelings. Often this leads to chronic depression. Taming the mood swings. Any form of physical exercise helps keep the mood in balance. This helps in keeping the aggressiveness under check. Sex is also a great way to release the stress and feel better, rather than snapping and using profanities. Another helpful way is to ask yourself 'why'. Whenever you feel that you are doing something irrational or out of character, ask yourself why. The answer you get from yourself will help clear the situation and you will end up handling it in a mature fashion. The irritable male syndrome. This is the male equivalent of the female menopause - The Andropause. It covers the symptoms seen in middle-aged men that occur due to the drop in testosterone levels. Like women, men show mood changes, bouts of irritability, grumpiness, hypersensitivity, anxiety and frustration. The recent research on men having mood swings and the society's acceptance of these findings is very encouraging. It helps stress in the fact that men are emotional too. There is nothing anti-macho about a man crying his heart out at times. It only shows he is human, after all.
What to eat when you breastfeedAlmost everyone around you will advise you to eat a calorie-rich food that will aid in milk production from your body. But did you know that your body is quite capable of producing enough milk from whatever you eat? Your body has stocked up on all the fats during your pregnancy days itself. You don't really need the extra calorie rich food just to produce milk for your baby. However, how much calories you need cannot be predetermined. Let your body determine your needs. Eat as often as you want, as often as you feel hungry, but remember to eat foods that will give your body the nutrients and not just satiate the hunger. Opt for whole grains, pulses, fresh fruits, legumes, fresh vegetables and nuts. Choose natural drinks like buttermilk, coconut water, and fresh juices. Remember that the foods that you choose must nourish your body with proteins, calcium, and iron other than carbohydrates. Dried fruits and nuts like cashews and almonds and walnuts are the traditional foods given to new moms to enhance breast milk confinement. They are a very rich source of calories and definitely improve the quality and quantity of milk. However, keep a bottle of water or some juice nearby when you breastfeed. The body releases oxytocin when you breastfeed and it makes you thirsty. So, have some refreshing drink before you breastfeed. Most new moms are advised to drink lots of water as it aids in breast milk production. However, breast milk production doesn't really need extra water. It is best to avoid alcohol when you are breastfeeding. The amount of alcohol in blood and breast milk reaches its highest level about 30 minutes after you have a drink and it lowers down only after about four hours. Drinking alcohol is not advised when you breastfeed, however, if you feel like having alcohol, do so after you feed your child. Also, wait for a minimum of four hours before you feed next. Ghee is another item that new moms are encouraged to consume for milk production. However, if you are eating a balanced diet there is no real necessity to eat too much of ghee. Avoid aerated drinks, tea, and coffee while you are breastfeeding. Similarly, junk food and foods that are not cooked at home are best avoided. These types of foods fill you up, but provide no real nourishment. Herbal teas are considered safe drinks during breast feeding. However, consult your doctor before you consume any herbal medicines. Do not forget to take your prescribed supplements of iron, folic acid, and calcium regularly during breastfeeding. Your body also needs more amounts of vitamin C, vitamin B12, zinc, and vitamin A. These, you may obtain by eating foods that are rich in them or your doctor might prescribe supplements. Weight gained during pregnancy may be a concern now and you may want to lose it to regain your pre-pregnancy shape. Remember to lose weight gradually with the help of a balanced diet and moderate exercise. Do not starve yourself. Also heavy exercising may release toxins into the bloodstream and breast milk. Keep in mind that you will gain your original weight back only after your baby has completely weaned off breast milk and has started eating solid foods. Breastfeeding is the best option for your baby. It gives your baby everything that it needs and keeps it free of all diseases. Do not shy away from breast milk, do it the right way! Your body is quite capable of producing breast milk from the well-balanced diet that you eat and there is no real need for a calorie-rich food that new moms are fed.
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.
Activities to help your toddler talkWe understand how eager parents are to talk to their kid. They want to hear their soft voice and babble talks. So start teaching them as soon as possible to help them to speak fast and clear. Here are some activities which will help you to teach your kid to talk. The playful ways: The best way of teaching your kid to speak is to, well,play. Most of the learning is done through playing. Be a child with your child. Act playfully foolish --kids enjoy that a lot. And when the kid is happy and in playful mood, they try to talk. Building vocabulary: Use a word in more than one sentence to make them understand the meaning of the word. For example, 'The color of leaves is green' and 'Your father is wearing a green colored shirt.' If the kids hear a word used often in different sentences, it becomes a permanent part of their vocabulary. Give them practical examples: Teach them the names of the things they see around. Or get actual objects and be descriptive to teach them the name of the object and talk about the object's features. Use a toy phone: You must have seen kids trying to talk over phone to their dads or friends. They try to copy you the way you talk over phone. It can be a great way to teach them to speak. Pretend that you are talking to the kid's dad or grandparents, and pass over the phone to the kid and encourage them to chitchat over the phone. Story telling: Kids listen to the stories very carefully. Show them the pictures in the storybook and describe them with the story. Then repeat the same story the next day. Ask your child if she/he remembers what was there in the story by showing them the picture. Help them if they get stuck. Sing together with the child: Music is another amusing way to teach the child to speak. Listen to a song, sing and dance along. Encourage the child to dance and sing with you. Children are great at learning lyrics of a song. Reward the child on completing a task: When you reward the child with his/her favourite toy or snack, they understand the benefit of performing the task. And they take effort to get the reward. Ask your child to recite a poem for you, or speak a certain word or sentence and entice the child by showing him the reward he will get on completing the task.  
LBW - Babies that don't throw too much weight around!You'll hear this term if your baby weighs less than 2.5 kg (5.5 lb) when born. About six in 100 babies who are born in the UK have a low birth weight. There are a number of reasons for LBW in babies, with premature birth topping the list as far as reasons go. Babies born prematurely could have extremely low birth weight as compared to babies that are born between the natural term of pregnancy, i.e., between 36-40 weeks. So what are the other reasons behind LBW babies? Descent is an important factor that could also determine birth weight. A survey conducted in the UK showed that children born to people from the Indian sub-continent (Indian, Pakistani, or Bangladeshi) or African parents are more likely to be born with LBW as compared to babies born of white Caucasians. In case of twins or triplets, there are chances that one or all offspring might have LBW due to lack of space in the womb. The mother's health would largely determine the healthy weight of the child as well. Emotional problems faced by the mother during pregnancy could have a link with LBW. Same goes for addictions like smoking, alcohol abuse, designer drugs, and at times, health conditions like high blood pressure which cuts off healthy blood supply to the fetus. Even damage to the placenta can cause LBW, as the fetus does not receive vital nutrients, blood, and oxygen which can cause stunted growth or low weight at birth. Any congenital or hereditary conditions can also affect the baby's weight. There is much uncertainty with regard to the future of a baby with low birth weight. There have been instances where LBW babies have developed conditions like obesity, diabetes, or heart disease in later years. It is a common fear that LBW babies develop behavioral or emotional problems in schooling years and they are likely to have low intelligence. Of course, there isn't any concrete evidence. The pivotal factors here would be to find the cause for LBW and what trimester of pregnancy was it detected. Providing a stable family environment and taking special care of a LBW baby can also go a long way in keeping it healthy in subsequent years. Not to forget that the parents' size and genetic predisposition would have a lot to do with the baby's health and even weight. If the parents are small in size or underweight, then the chances are that the baby will be born small or with LBW. Breastfeeding the baby is the best strategy that a mother can adopt to ensure that the baby grows up well. While growing up, the parents will have to ensure that the baby receives a balanced nutritious diet to ensure healthy weight.
Crave for non-food substances to put in your mouth? Go ahead take your pica!We all have strong cravings in some form or the other, especially for food. Just thinking of a chocolate cake or ice cream can set the mouth watering and the hand creeping to open the refrigerator. However, some people have an unusual craving and it is to consume non-food items. Everyone knows that children are known to eat chalk, dirt or lick walls but at times, even adults have this unusual craving for non-food items. This condition is termed as 'Pica'. One can understand a child popping something into its mouth as it's discriminatory skills are not developed, but what about fully grown adults who have this habit? Is it a mental ailment? One can't really call it a full blown mental condition as it occurs commonly in pregnant women. The cravings are as strong as any other food craving and sometimes these people go out of the way to satiate their cravings. So, right from paint thinner, to chalk to ink, ice, plaster, paint, linoleum to plastic bits can form the obsession or craving. Pica is a combination of psychological and biochemical processes and is generally a deficiency which sets about these intense cravings.  When pica strikes pregnant women, then it could be a cause for much concern and the doctor should be kept informed. While it is easier to indulge a pregnant woman's ice cream cravings if she also develops a thing for iron fillings on top of her ice cream, then obviously it can be a rather dangerous thing to do. Ice and chalk are comparatively harmless and other than affecting the teeth and the taste, do nothing much else, but what about turpentine and toxic materials? They can definitely interfere with the body's digestive processes and can even spread harmful toxins in the body to cause blood poisoning, intestinal infections, bowel blockages and lead poisoning or arsenic poisoning.  If you have such strong non-food cravings then before you give in to them talk about it to a medical practitioner. It could well be an iron deficiency or perhaps even anemia which is attracting you to chew pencils up or making you pop dirt in your mouth. If you are pregnant then certainly the doctor will need to address the underlying issue and ensure that the pica goes away before you deliver. Wouldn't want you chewing up the baby's soother now would we?
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.
Stay healthy, keep flu at bayKeep the influenza virus away from you by following these simple routines : Wash your hands!Hands are a germ factory. Innumerable things are touched by us through the course of a day and that lends the germs a perfect breeding ground. Hence, it becomes imperative that we clean our hands thoroughly, especially before eating. Always keep a sanitizer handy in case you don have access to water and soap. Even while you wash your hands with soap and water, do not rush with the process. Wash thoroughly at least for 20 seconds. Clean the surfaces!Computer keyboards, tables, pens and pencils, shared stationary are all great places to find the flu virus. Regularly clean these surfaces with an alcohol-based disinfectant that will kill these germs. Exercise!Nothing can be as good as regular physical exercise for maintaining good health. Regular exercising boosts the immunity. This makes you fall ill less often. It also gives you greater resistance against viruses so you will not be affected by them no matter how strong the exposure. Top up on vitamin C!Vitamin C is known to boost your immunity levels. It also increases the resistance against viruses. Eat a lot of citrus fruits like oranges and tomatoes. Amla, that is a rich source of vitamin C, can also be consumed in the form of juice or eaten raw! Chicken soup for the ill-soul!Chicken soup is known to be the most effective against the flu virus. So if you feel you are coming down with a flu fever, rush to the kitchen and fix up some nourishing chicken soup for yourself. Nothing works as effectively as this does. Try poking yourself!The ancient Chinese system of medicine, acupuncture, has been known to treat everything from headaches to nausea to arthritis. Acupuncture experts may prick at particular pressure points with hair like needles to keep flu at bay and to reduce the severity if already infected. Though there is no significant scientific evidence against it, there is absolutely no harm in trying it, if you can tolerate the pain from the needles!. OTC drugs!Over-the-counter medications are available in plenty for flu symptoms. The achy feeling all over the body, the sore throat, and the muscle pain are the worst symptoms of flu. Doctors suggest that you do not over-medicate yourself. Instead of going for multi-drug combinations, doctors advise you go for generic medicines like acetaminophen for fever and a cough suppressant. Garlic pods!These smelly things can be of great use when it comes to prevent a lot of diseases, the flu included. Studies show that people who ate two or three pods of garlic daily had better resistance against the flu virus and fell ill less often. Proactive Probiotics!The strength of your immune system lies in your gut, called gut-associated lymphoid tissue or GALT. Almost 80% of the immunity comes from your gut. To keep the gut healthy, eat a lot of probiotic, pro-GALT foods like yoghurt. Sleep well!Sleep is the most essential component of staying healthy. A well-relaxed body is fitter and stronger and will have better immunity against diseases! Prevention is always the better form of cure. Stay protected and stay healthy.
Treating sore throatTest and diagnosisPatients with sore throat are examined by ENT specialists. At first, the doctor performs a local examination of throat. Clinical examination usually guides the doctor towards diagnosis. Although in order to confirm the diagnosis, the doctor may ask for culture and sensitivity test of the throat swab. Treatment Home remedies: Mild cases of sore throat are usually cured by home remedies. Following remedial measures can be adopted at home: Warm saline gargle – Gargle with warm saline water helps to relieve the discomfort and irritation of the throat. Half to one teaspoonful of salt is added to one full glass of warm water and the patient is advised to gargle. This process may be repeated 3 to 4 times a day to have a soothing effect on throat. Additionally, smoking and use of other tobacco products must be avoided. The patient must drink adequate amount of fluids. Warm liquid and semi-solid food must be consumed to provide a soothing effect on the throat. Cough lozenges to help relieve irritation and pain in the throat. Seeking advice of the doctor: If the signs and symptoms persist and are not adequately controlled by home remedies, the patient must seek advice of a specialist doctor. Viral infections usually do not require treatment. They are usually cured in 5 to 7 days. Bacterial infections require treatment as per the advice of a specialist doctor. Bacterial infections may require treatment by antibiotics. The treating doctor selects an antibiotic which is suitable for the patient depending on factors such as the age of the patient, report of the culture and sensitivity of throat swab, previous drug history of the patient, etc. Antibiotics usually effective in bacterial infection with sore throat are from the group of penicillins, cephalosporins, and macrolides. PreventionViral and bacterial infections are contagious. Good hygienic lifestyle and habits help prevent infections. Following things to be noted are: Frequent and thorough hand washes before consumption of food, after using toilet, and after sneezing and coughing. Use of a hand sanitizer during consumption of food outside home. Avoid sharing food and drinks from same glasses and utensils. Use a tissue paper or handkerchief while sneezing and coughing. Avoid close contact with patients with sore throat. If sore throat develops, few home remedies may prove to be curative. If sore throat persists, advice of a specialist doctor must be sought.
Women and impotence- The facts on sexual dysfunction in womenTraditionally when one hears the word 'impotence', one tends to associate it with the male partner. Female impotence is also a reality. Sexual dysfunction in women might infact be more common in women than in men. Read on to know more The sexual response cycle has four stages- excitement, plateau, orgasm and resolution. A problem arising in any of these phases is called Sexual Dysfunction. It hampers with the pleasures of sexual activity. All in all, a healthy lifestyle is the key to getting rid of several of the causes that may cause sexual dysfunction. Be frank and express your fears to your partner. Talking and establishing a mutual respect and comfort zone helps like nothing else can! Sexual dysfunction affects females as much as it affects men. The causes can be classified as below: Physical causes: Several diseases like diabetes, heart diseases, kidney disorders, liver disorders, neurological disorders, hormonal imbalance, menopause, excessive alcoholism or drug abuse can cause sexual dysfunction. In addition to it, inability to perform or initiate or enjoy sexual activity may happen due to side-effects of certain medications. Past pelvic surgeries are also a cause for sexual dysfunction in women. Psychological causes: The mind has got a definitive effect on the body. Sexual dysfunction is the apt example to explain this. Too much of stress, work pressure, depression are factors that do not allow an individual to perform well in bed. Past sexually traumatic events may also be a cause for sexual dysfunction. Sexual causes: This is the most frequently encountered cause for sexual dysfunction in women. Vaginusmus is the leading cause here. Vaginusmus is a pain that the woman experiences due to the fear of penetration. This causes involuntary contraction of the muscles making it impossible for her to relax. The origins of this fear are due to past painful and traumatic experiences. Dyspareunia is another cause for sexual dysfunction. It is a burning pain that lasts long after the act is over. The severity of the pain is of such a nature that the woman prefers not giving in to the pleasures of sex rather than experiencing pain. Sexual dysfunction is not something to be embarrassed of and certainly not something to be looked upon derogatorily. Sexual dysfunction often leads to frustration and can affect your relations. Speak out and seek help before it is too late. And for the men reading this, be supportive of your partner. She is going through a difficult phase and she needs your love and support along with the right treatment, not your scorn and displeasure. Treatment Options: Sexual dysfunction in women is treatable once the exact cause for the condition is known. Various natural remedies, holistic approaches and psychotherapy have been used with a good measure of success. Additionally, oral medication, hormonal therapy and surgical procedures are also used to treat impotency.
Sex during pregnancy? It's possible!One of the questions that arise when a woman gets pregnant is whether it is safe for the couple to have sex. We'll try to answer the most common questions couples tend to ask. Is sex safe during pregnancy? Sex is considered safe if the pregnancy is normal in all stages. However, even if it is safe, it doesn't mean the woman would want to have it. Desire for sex fluctuates during the various stages of pregnancy and sex becomes plain uncomfortable as the body gets larger. What is not safe? Two types of sexual behaviors are not safe during pregnancy. While having oral sex, the man should not blow air into his partners' vagina. It can lead to air blockage of blood vessels by an air bubble, which is called air embolism, and can be lethal for both mother and baby. The pregnant woman should strictly avoid sex with a partner with unknown sexual history or who may have a Sexually Transmitted Diseases (STD). What are the common risk factors? In case of significant complications with pregnancy, abstinence from sexual intercourse is advised. Common risk factors can be: Threat of miscarriage. One can have pre-term labor or signs indicating the risk of pre-term labor (such as premature contractions). Unexplained vaginal bleeding, discharge, or cramping. Leakage of fluid surrounding the baby, called as amniotic fluid. Placenta previa, a condition in which the placenta (the cord connecting mother to the baby and nourishes the baby) is located low down and covers the opening of the uterus. Cervix incompetency, a condition where cervix is weak and dilates before full term, increasing the risk of miscarriage or premature labor and delivery. Can sex during pregnancy harm the baby? The baby is always protected by the amniotic sac (a bag-like structure that holds the fetus and surrounding fluid) and uterine muscles. A thick mucus plug seals the cervix and protects the baby from infection. The penis does not come into contact with the fetus during sex. So, sex can't harm the baby directly. Can orgasm lead to miscarriage or contractions? The contractions felt by pregnant women during and just after orgasm are totally different from the contractions of labor. Therefore, in cases of normal and low-risk pregnancies, orgasm can't cause contractions and miscarriage, but always check with the doctor and make sure that your pregnancy is in the low-risk category. What are the safe positions for sex during pregnancy? The old standby missionary position for intercourse may not work for you now. Instead, try these options: Spooning: Lie side by side with him behind you. This will not put pressure on your belly, and makes for more shallow penetration. Female on top: There's no pressure on the belly, and the female can control the speed and depth of penetration. Side of the bed: The female lies on the back on the edge of the bed with knees bent and feet on the edge. The male stands facing her. It's like classic missionary, but the male won't be resting his body weight on the pregnant female. However, remember 'normal' is a relative term when it comes to sex during pregnancy. You and your partner need to discuss what feels right for both of you and take advice from the doctor.
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