#Sleep Apnea Effects

[dynamichealthinsights]

How Poor Sleep Can Exacerbate Respiratory Conditions

Sleep is a fundamental component of overall health, influencing nearly every aspect of our well-being. While most people understand that quality sleep is essential for cognitive function and mood stability, its impact on respiratory health is equally significant and often underestimated. Poor sleep can aggravate a range of respiratory conditions, including asthma, chronic obstructive pulmonary…

[the-gayest-sky-kid]

guys if you're on hrt how did you know it was like the right choice for you

[ed-nygma]

Last post is so funny cause half of the people rb'ing are like #omg yeah it's 2 am already ☠️ and the other half are like #yeah it's 7 am I haven't slept in 36 hours I think another coffee cup might fix me tho

[grsmedical]

Common Myths about CPAP Therapy Debunked

If you're considering using a CPAP machine to manage your sleep apnea, it's essential to understand the potential risks and side effects associated with this treatment option. Normand Lapointe is a Respiratory Care Practitioner and Founder/Owner of GRS Medical. He says that CPAP machines are generally safe and effective, and the majority of side effects are minor and can be easily managed.   

What are the common side effects of using a CPAP machine?  

The most common side effect is mouth dryness, which can be alleviated by using a humidifier attached to your CPAP machine. Other possible side effects may include aerophagia (bloating or gas), bleeding nose due to lower humidity, dry eyes caused by mask leaks, nasal congestion, headaches, and skin irritation. It's important to note that rare cases of pneumothorax (collapsed lung), arrhythmias (irregular heartbeats), or hypotension (low blood pressure) have been reported, but according to Normand, these occurrences are extremely uncommon. 

How can the side effects of CPAP machines be managed? 

If you experience any side effects while using a CPAP machine, Normand advises that you contact one of his sleep disorder clinics in Montreal and Quebec. His team of sleep specialists can provide guidance and support in managing these issues. Most side effects can be easily managed with some trial and error, such as adjusting mask fit, using a humidifier, or exploring different mask options. It's important to remember that the long-term benefits of CPAP therapy in achieving restful sleep outweigh these minor side effects. 

Understanding the potential side effects of CPAP machines is vital when considering sleep apnea treatment options. Normand and his team of sleep experts at GRS Medical can help get you set up with your CPAP machine and ensure your comfort and overall well-being. Don't hesitate to reach out if you experience any side effects while using a CPAP machine. Remember, a good night's sleep is crucial for your health, and with proper management, CPAP therapy can significantly improve your sleep quality and overall quality of life. 

[designgraphicruby]

No Sleep? How to Prevent Sleep loss

[longhaulerbear]

Among patients with previous COVID-19, OSA impact the development of incident glycemic, neurocognitive impairment, and abnormal functional pulmonary changes that persist up to 1 year since acute phase.

[neuroticboyfriend]

reminder that seroquel is neurotoxic. as in, toxic to your nervous system. i understand some people are willing to deal with that for the medicinal benefit but i need every person on this to know. you are taking a neurotoxic substance.

you are taking a substance that acts on 47? receptors in your brain (most medications act on one to several but my god not 47). it is an anticholinergic (class of medications that have been linked to dementia), an antihistamine, and it blocks serontonin. it is basically a chemical lobotomy and in fact, thats how some doctors describe antipsychotics when they were developed - as a chemical alternative to a lobotomy.

it also carries risk of metabolic syndrome, movement disorders, increases stroke risk, (rarely) can increase your QtC interval (heart thing) leading to a condition that causes sudden death. if you have sleep apnea or POTS it can make that worse - same with diabetes and insulin resistance. i could go on. the side effects from this are many and serious.

i dont have energy for sources now so please factcheck me and do your own research but by the love of god.. i just want mentally ill people to know the risks of their medication so they can make an informed choice. especially since many of us are on this for years, indefinitely, effectively for the rest of our lives.

please, if you're on any antipsychotic (or any medication), do research and do what's best for you. ask for alternatives if you must. you deserve and need a good quality of life and it is entirely understandable and normal for the risks and harms of these medications to outweigh the benefits.

if you continue to take these please monitor your health and implement preventative measures. be safe. you are loved.

[a-little-revolution]

hey elliot! this is a surgery question, so please take all the time you need to reply. you've mentioned you had top surgery before, and i was wondering what it was like accessing that kind of care as a little person? was it challenging finding a surgeon willing to work with you? what sort of considerations were needed for your surgery and recovery, if any? i was also curious if you had used a binder before surgery, and how you found it? i have a hard enough time donning and doffing mine with long arms, so i'd imagine it could be quite challenging for you, but maybe you found ways around it! thank you for all your hard work and patience in educating folks. wishing you bountiful spoons and lots of restful, easy days 💚

Hello! Thank you so much for your patience, I did indeed take some time to process this - I'm more than happy to answer questions related to surgery on here, as it's such a large part of my experience as a little person, but I may indeed take some time to respond as I have medical CPTSD.

Anyhoo lol Yes! I have had top surgery, and my dwarfism did effect how I accessed that care:

Because I'm at risk for spinal injury, my surgery was done at a hospital rather than an outpatient centre where most top surgery is conducted (I needed to be kept overnight for monitoring while most top surgery patients leave day-of)

Like for all my surgeries, my sleep apnea and oxygen levels needed to be monitored

But unlike my many other surgeries, this particular hospital (which will remain nameless for my own security) was incredibly inaccessible despite it being obviously well funded. No stools to be found, the wheelchairs were so high and designed with an almost bike-like frame that I needed to be liften in and out of them, and the staff was unfriendly and ableist.

My surgeon was picked for her experience with little people rather than her experience with top surgery. (I ended up unhappy with my results because my surgeon was more familiar with breast reductions and didn't follow through with my wishes. My top surgery was actually the worst surgery experience I've had - I was repeatedly dead-named by members of the hospital, overdosed on anaesthesia, and my surgeon had a terrible bedside manner)

But my touch up surgeon was my first choice! Dr. Armstrong at McLean Clinic did a fantastic job straightening my scars and removing my nipples (which I had hesitated on for the first surgery but firmed up for the second. I love having no nipples!)

Image description: a photo of my torso and lower face, displaying my healed top surgery results. Two wavy pink scars line the bottom of my pecks, and I have no nipples. With one hand on my hip and the other on my upper chest, you can see my tarot "the fool" tattoo, my kissing crows, and my sailor mercury star. On my right hand I wear a red glass ring to honor my deity Hestia. I have pail skin, a short brown beard, green curly hair and a gold vertical medusa piercing.

Post-op care was understandably different for me. Since my arms are already short and locked, the limit to my range of arm motion affected me even more. I needed even more help with care tasks than that of an average height/able bodied patient. I was lucky to several loved ones around to help :) Though compared to other surgeries, I was happy that I was able to walk and be more independent for the most part.

I also just want to add: something I see a lot on social media is trans and nonbinary folks seemingly bouncing back from surgery effortlessly. We see them at the beach, posting photos, and it gives the illusion that top/gender affirming surgery isn't the painful, emotional, difficult thing that it is. IT'S OKAY IF YOU DON'T FEEL QUEER JOY IMMEDIATELY AFTER SURGERY!! It takes a while to heal and bounce back because it is a lot on your body! Take your time, and give your body the love and care it needs!

Anyway I hope this all was helpful/educational - and I wish all my queer, trans, and otherwise gender diverse followers a lovely day!!

[pain-is-too-tired]

You know what, should've done this last month,but heck I'm combining stuff for this month as well so-

Queer and Disabilitiy hcs for PJO characters

(I'll be mostly mentioning physical disabilities, but pretty much all characters are adhd and dyslexic(and ptsd) and will probably add lot as autistic so gdgd.)

Percy

I havnt really thought much on his Sexuality and such, maybe Bi?

Think he at least suffers from some form of asthma/ breathing related disability due to Tarturus. Drinking fire can not be good for your throat,definitely sleep apnea. Maybe back/ muscle problems from strain of holding up the sky? Not sure what that might do to someone tbh hdgd

Annabeth

Same as Percy pretty much, don't think much on her Sexuality and identity before and the same experience in Tarturus and the Sky holding stuff.

Think she also has some what of a permanent injury with her ankle/leg. At least enough to effect how she walks and such.

Also. Autistic, maybe ocd?

Rachel Elizabeth Dare

Aroace. I stand by that.

Also, her visions I feel like could be enough to be considered a disability. Maybe similar to Epilepsy? Since it can happen randomly and she collapses from it and all that. Like yeah it's part of her job description, but still hard to find a human job with that I feel.

Piper

Queer/Unlabeled, pretty much canon.

Leo

Demiromantic Graysexual

Probably some muscle issues and such post death? Or something like Fibromyalgia or Neuropathy

Autistic

Jason

Apagender(Gender Apathetic, just think he really don't care too much on how he's perceived gender wise-) Nebularomanic and Pansexual. Constant confused feeling of "do I like them or are we just really close friends-" feels fitting to him. Gdgdf

Also, canonically needs glasses. I feel probably partly due to getting hit in the head so often fgdf

(Also I could see him with visual snow/ static)

Maybe heart problems related to the use of electricity effecting his body? Like POTS or something hdgd

Also. Autism.

Nico

Gay(canon)

Similar lung problems as Percy and Annabeth cause Tarturus. Probably more issues related to being in a death coma in a jar. When he shadow travels/uses his powers too much he passes out cause of low electrolytes and blood sugar(cue Gatorade and Kitkats)

(most demigod abilities uses your electrolytes and sugar/carbs but powerful ones like shadow traveling where your form literally shifts uses more. In this essay I will-)

Also. ✨️Tism✨️

Will

Bi(canon)

I do love the hard at hearing hcs ngl hdgdf

After tsats,probably has same lung issues.

When using his healing also feel he uses a lot of his own needed electrolytes/vitamins and such which can give him a deficiency depending on how often he's doing it

Also Tism

Kayla

Aroace(I can not explain why if feel this fits but I do)

Type 1 Diabetes. Uses Insulin pump, Will has to stay on her case about keeping up with it fsgdg

Lee

He/They

Panromantic Graysexual

For the short time after, had complications from an injury from the Drakon fight.

Michael

Demi

Tism(especially sensory issues with sounds)

Jake

Queer(canon? We know he came out but nothing else. So you know what? I give him Queer label cause I can and feel like it'd fit him.)

Honestly probably so many problems from injuries. My man was in a full body cast guys.

Tbh, feel like all the Hephaestus cabin is Autistic. Feel in my bones.

[thedisablednaturalist]

If you have mysterious chronic pain and have the means, here's a list of doctors you should see other than your primary and a rheumatologist:

Neurologist and/or sleep specialist

Pain management doctor (also sometimes called pain and spine doctor)

Therapist that specializes in helping physically disabled people (having chronic illness sucks and you need someone to talk to)

Psychiatrist (most people with chronic illness also need psychiatric meds)

Physical therapy or rehabilitation center that specifically has procedures for chronic illnesses. My chiropractor acts as this for me but I'd only recommend that as a last resort. If you have something like fibromyalgia or ehler dahlos syndrome you need to be very careful with how you stretch and how much exercise you do. My chiropractor has special exercise equipment that is very gentle and has a lot of padding to reduce pain.

ENT (Ears, nose, throat doctor)

Nutritionist

A primary care doctor will at most only perform blood tests. Many illnesses do not show up on these blood tests. You want to get checked for rheumatoid arthritis, lyme disease, and lupus. Even if your doctor tells you it's because your vitamin d level or iron is too low, I would still recommend further testing.

They'll most likely refer you to a rheumatologist regardless, but unless you actually have arthritis I wouldn't rely on them too much. Mine charged too much for a 10 minute appointment where all she did was give me meds and would not discuss any other treatment or management options. She also laughed at me when I asked about a mobility device. It might just be I had a bad experience but it seems like those doctors are just given chronic illness patients cause no one else wants them.

You need to get your spine looked at. An MRI is essential. At the very least get an xray of your neck and spine. A neurologist or pain + spine doctor will most likely order one.

Neurologists will check your nerves and brain function. They'll check if your nerves are overly sensitive or unresponsive. You'll get stabbed and shocked a lot.

Pain and spine doctors are the ones who will give you pain medicine. It will not be immediate. They will need to examine you (MRI) and try other medications and treatments first. This is because insurance is not going to pay for stronger drugs until you've exhausted other options. You'll most likely start with something like duloxotine, gabapentin, prescription NSAIDs, and/or muscle relaxers. Once my results came in from the MRI I was given steroid shots in my spine. They will give them in different spots first to see which spot is most effective, so don't worry if it only works one time and not the others. I cannot stress the importance of having this type of doctor on your care team. Being able to have the power to manage my pain has helped so much. This is also the doctor that signed my form for my handicapped parking permit.

Sleep studies are expensive, but sleep is extremely important for your quality of life. So many people have sleep apnea and don't know it. CPAP machines today are really quiet and comfortable. This will be essential for tackling chronic fatigue.

An ENT doctor is only if you end up having sleep apnea or have any issues with your sinuses. I had to go and get my nose fixed because even with my cpap I still wasn't getting enough air.

You need to have some way of moving your body. Only do this after you are already on a treatment plan. It's hard to do things like exercise when you are still dealing with pain and fatigue. Doctors will want you to do physical therapy first but that's not a good idea because you won't stick with it due to pain. You need to deal with the underlying problems before working on stuff like exercise and nutrition. Able bodied young people who don't exercise and don't eat well are not in constant pain, so you shouldn't be either. If they tell you to lose weight drop the doctor, that's a cop out response.

I haven't reached the step to get a nutritionist, but changing what foods you eat and when can really help with pain management. You also may find that something you eat is exacerbating your symptoms.

With my insurance plan I can pretty much call up a doctor and make an appointment without a referral. I know some plans need referrals, so either call your insurance for one or get your primary care doctor to give you one. Idk how this works for medicare but I think you can just make an appointment with anyone who takes medicare.

I have not been able to obtain a script for a mobility device from any of my doctors. If you have a type of doctor you'd recommend for that please chime in. I've heard occupational therapists are the way to go though but still need to look into that myself.

Also do not feel bad if you cannot afford these. It is not your fault. Healthcare especially in the USA fucking sucks. This is mostly only useful for people who are in the investigative stage who have insurance. I'm not saying "oh just do yoga". Your pain is not your fault, and it can take a long time to figure out a plan that's right for you. I didn't know what doctors I was supposed to see when I started out, and was just given to a rheumatologist since there isn't a fibromyalgia doctor. I only had blood tests at that point. Hopefully this helps people save time and make sure they can fully investigate the cause of their pain (or at least how to manage it better)

[delphinidin4]

Narcolepsy isn't just falling asleep all the time.

That's the version you see in movies. Narcolepsy is when your body has trouble with when to switch between waking and sleeping modes. Here are some symptoms of real-life narcolepsy. Not every person with narcolepsy will have all these symptoms: some are more common than others.

Excessive daytime sleepiness

Sudden loss of muscle tone caused by intense emotion (laughing, anger, surprise, etc may cause effects like slurred speech or your knees buckling)

Sleep paralysis (being unable to move while falling asleep or waking up)

Hallucinations (often combined with sleep paralysis)

Moving into REM sleep (dreaming) within 15 minutes of falling asleep (most people take 60 to 90 minutes to get into REM)

Insomnia

Other sleep disorders, like sleep apnea

If you think you may have narcolepsy, see your family doctor about it, or make an appointment with a sleep specialist.

About one in 2,000 people have some form of narcolepsy. However, it is thought that about 50% of patients with narcolepsy may be undiagnosed (source). Even if you don't have these symptoms, consider reblogging so the most can reach more people with undiagnosed narcolepsy!

[witchofspades]

CW: obesity; gastric bypass surgery; food/eating disorders

Sometime a few years back I did a 6 month program to check if I was capable of having gastric bypass surgery. It’s meant to force you to lose weight quickly, by eating less than your body needs in a day. It’s mostly like keto-dieting but more extreme.

I lost 20 kilos in 6 months, which, great. Whatever. But I decided I didn’t want the surgery because if I could lose weight by myself, I clearly didn’t need an operation to do it.

Now I’m struggling again thanks to my family’s bad eating habits, and I went in for a sleep-apnea test. I was diagnosed with sleep-apnea, but I was told I had to do a gastric bypass surgery (again), and I’m just so tired.

I don’t know if anyone is familiar with this sort of thing. I’m always doubting surgeries unless it’s small, but cutting out your stomach entirely sounds incredibly bad. Like that’s…not something I can understand from the stand point of long-term health.

I’ve tried researching it, but it’s near impossible to find any information that isn’t completely one sided. It’s either insultingly fatphobic, or then way too far leaning into the “nothing wrong with being overweight” side even though it’s clearly having an adverse effect.

I’m constantly working on losing weight, trying to limit my meals, trying not to have too much sugar, exercising every day despite my chronic pains, but I can’t seem to get it to go down naturally no matter what.

If anyone knows anything, please tell me… I’m so tired and confused, and I need help.

[tactax-art]

I gotta know: What is an Alb? Because I have never heard of that before and google is literally no help.

You can always read the fic if you want the slow-cooker version, but i've copypaste&updated the text from an earlier ask about the same thing, because that og post contains Soap related spoilers (They are tagged "tactax EoE spoilers" btw.)

Ghost being an Alb is generally inspired by the german "Nachtalb" (english wikipedia is kinda shit). I'm not aiming for him to be precisely that, but it was my jumping-off point.

Ghosts abilities aren't something I've revealed much yet in the fic but he's a kind of fear entity.

Alb's are myth's answer to sleep apnea, sleep paralysis, nightmares, and night terrors. As such he sustains himself on causing/witnessing nightmares, fear (more effectively when it's during people's rest but also when awake), stealing breath, eating dreams (as a rare treat) etc. I'll probs keep some of the mischief Albs are known for, not that anyone would believe it's Ghost which he finds super funny.

His body is sand based, as a nod to the sandman (folklore), golden sand being dreams he consumed and black his base being from nightmares. His bed's full of sand. His gear is full of sand. He prefers knives to guns cause guns and sand don't mix and having to keep it all together is so annoying. It's rumoured Ghost can control shadows, but it's actually his own black sand he moves around.

The skull mask is his actual face.

[bodyalive]

How to Shift the Body into the Parasympathetic Side of the Nervous System

Breathing out and holding out or pausing at the bottom of the breath amplifies the body's natural production of Nitric Oxide, a vasodilator that expands the porosity of our vascular system. During Covid, researchers at Massachusetts General Hospital found that Nitric Oxide improved respiratory permeability & bronchodilation. (They were not looking for the vasodilation effects but I’m sure that must have been happening too.) I first learned about breath holding out from Rosealba Courtney DO Lac from Australia, who used it to test Eucapnic metabolic health, the O2/CO2 exchange rate in the lungs. This was a contributing factor to asthma and sleep apnea and restricted breathing exercises could be used to cure asthma. Then I encountered this again studying at the beginning level with Lois Laynee. She had adopted a practice of Breathing out while humming to increase Nitric Oxide and Vasodilation and used it to calm the nervous system. One of the key actions to making the shift was swallowing at the bottom of the breath before inhaling again.

Signs that the parasympathetic nervous system is coming back online in the body:

+Spontaneous swallowing. When we are in a state of shock, our mouth dries up, we don’t produce saliva (neither are we producing digestive enzymes), and in order to swallow our food we need to drink something. Eating when in a state of stress, you can’t digest your food.

+Intestinal gurgles and rumbles. Have you noticed that when a client begins to relax that their organs and intestines begin to gurgle? As the parasympathetic wakes up, the viscera wake up.

+Yawning. Did you know you can make yourself yawn simply by rubbing your jaw muscles vigorously with your fingers and opening your mouth wide anticipating/expecting to yawn. Fake it til you make it.

Putting these two things together has enabled me to work effectively with shifting people out of long Covid symptoms. It has become my conviction that breathing dis-regulation is the metabolic habit that locks our nervous system into the Sympathetic side of the CNS where natural healing and self regeneration cannot happen due to the ‘emergency’ metabolism associated with the fight for survival.

[Thanks Jocelyn Olivier and Neuromuscular Reprogramming]

[our-transmasculine-experience]

Hello again. I was the anon a while back having scary side effects from my hrt. As yall advised I told my doctor and she ran some tests. It looks like I've developed a small heart condition from the T? Which might have also triggered sleep apnea, so I'm getting a mask to help with that at night and meds for my heart.

All this means I can no longer take T for my transition, but I cant go back to living as a woman. I'm not a woman, I refuse to lie to myself. What else can I do other than dressing more masculine or getting shorter haircuts to pass better? Are there any OTC things I can take? Has anyone else had issues like this and know if I can start again once my heart recovers when im older?

if you don’t mind me asking, what’s the name of the heart condition? i’ve never heard of someone developing a heart condition because of testosterone.

i’ve heard that minoxidil can help for facial hair growth, but i haven’t tried it and i don’t believe it’s FDA approved for that specific purpose, but i’d look into that.

i’d also look into voice training. facial hair and voice deepening are often the two most noticeable changes from testosterone. if you can, i’d look into taking private sessions for the best results.

i really hope that you can get back on testosterone one day, and wish you the best of luck!

[guardian5tiger3]

What's up?

General collective pick a group tarot reading.

Groups

1 2

3 4

5 6

Group one

So you guys are being excluded or not participating as much socially. Trust it's for good reason. The universe has or is going to give you a gift of some sort. You are also in a pretty good energy as of now. In terms of any mystery or something you don't know or can't see I see you taking proper actions at this time, wether that be moving slow and cautiously or whatever it may be depending on you and what's going on ok. Practice gratitude at this time or you are. Understand that you're future is very bright actually. I heard someone say "you just don't know." So this is someone's guide Im guessing or a spirit speaking on behalf of some of your guides. Either way so it seems that you guys don't understand yet how good you've got it. But seems like you're enjoying the journey and keeping your head up or you got to. Have fun if you feel called. Maybe go sit in the grass outside look at some flowers or something. Go pet someone's dog that's on a walk maybe. Whatever floats your boat. You got a destiny you're going to.

Group two

Seems like a transformation is taking place. Most of you an ending already happened or it is happening. Whatever was left behind, mainly something social it seems , or something about you and how you are presented to others. It could be anything though technically.. believe me what's coming in is superior. It's deeper and more enjoyable. Something about......... That kind of humor so idk ... You guys have developed quite a lot as souls and it's time you get something that matches up with that anyhow. And yah for somee of you it could be a loverr. Yay . Whatever it is it's better than whatever ended or died out what have you. Maybe you ended relationships or just cut chords. Idk basically, death and rebirth and a great majority of you are at least half way through it so get readyy!! If ya aren't already ..

Group three

Something about a bird maybe. Somebody could want a family and or somebody could desire to post things on social media that are basically to flex if it be of them on vacation, them with family, their dinner. Whatever, right.something about bacon and or pork. Maybe about blts. Like, sandwiches.someone from above is watching over you. Be proud of who you are. Something about say(ing) your name. Something about fairness when dealing with other people make sure everything is fair and everyone is content as possible equally. If something dramatic happens it's a test of somebody maybe your own character and how you might go about handling it so keep that in mind.

Group four

Somebody is having dreams they could be nightmares or very confusing or something like that. Most likely some type of distressing . Maybe causing insomnia. I heard sleep apnea. I looked it up apparently that's very shallow breathing while you're sleeping so maybe somebody need to understand nightmares or something could be the cause of that. Either someone needs more love in their life or you know who this is and you need to do something or some things to help them ok. This could just be making sure their waking environment feels more safe and comfortable and less stressful hopefully then they might stop having bad dreams right. Also not just on this but in general, watch out for trying to help people by trying to have them get into what you're into. Like look for this specific thing that I like to do and enjoy this the way I do and you have to feel better like I would. Just give them options and be cool about it, you know ? Offer them a leg up ,I heard. Hmm. This was a cool reading. I hope it helps. Also, if someone snores too much dude just get them something to clear their nose)sinuses it might help a lot.it might have a cool almost minty effect.

Group five

Hmm. Growing, learning, looking towards the future. Right? Well there's still something wrong or missing or something. I get that the past is over, but your emotions might not be so you may have to notice if there's something you have to deal with. Especially if this is trauma or just grief not processed /(all the way)try not to be too guarded or let yourself always find ways to be distracted. Also, it's ok to be angry. It's ok to be hurt. There's nothing wrong with that and there's nothing wrong with you. Look outside of yourself. You're only human. Also , for someone or some people it's something about a toaster... Make sure you guys are eating ok and drinking enough water. If you have a comfort food especially if it's toast or something... You might wanna go for eating that now.

Group six

So you're not getting along with someone or there's someone in your past being brought up right now to me. If something is going on in a relationship make sure you look at it without an ego . If you let someone go or are about to make sure you know that it's worth it and you won't regret that. Especially if this is just some type of miscommunication. I do understand needing to defend yourself especially so people won't look at you in a lower way or treat you worse than you deserve but you might want to be in a calm place and reflect on this deeply. It depends on the specific person what's going on and what to do about it so I'll just say it's up to you guys and just make sure you know what is the right decision and to pick that.