Best Practice Health
Best Practice Health
  • Видео 446
  • Просмотров 3 651 876
New hope: a study shows a promising treatment and possible cure for ankylosing spondylitis
From BestPracticeHealth.tv:
Ankylosing Spondylitis is an autoimmune disorder in which inflammation affects the joints and ligaments of the spine, leading to significant pain and eventually disability. The condition is relentless, painful, and progressive. Despite years of research, and an unusually good understanding of the genetics of the disease, treatments options are marginal at best. Until now. A new breakthrough therapy may bring hope to many patients suffering from this debilitating disease.
Breakthrough Treatment Option
An article on ankylosing spondylitis was published in the journal Nature Medicine today by a Russian research group. While I am not familiar with the scientists, thi...
Просмотров: 15 558

Видео

Seven months of low back pain, why won't my doctor order an MRI? | Non-specific low back pain
Просмотров 2,4 тыс.8 месяцев назад
Most people are not on Medicare, but a lot are. And most private insurance guidelines are very similar to Medicare. So, I've provided the Medicare guidelines here. MRI (Magnetic Resonance Imaging) of the back for back pain typically require that specific criteria are met to justify the medical necessity of the procedure. These criteria help ensure that the MRI is ordered when there is a reasona...
Julie's Journey from Low Back Pain to Hope
Просмотров 1,5 тыс.9 месяцев назад
Meet Julie, a retired teacher and coach from The Woodlands, Texas, whose active retirement was interrupted by debilitating low back pain. In this inspiring video, we delve into Julie's journey as she navigates the challenges of scoliosis, spinal stenosis, and mechanical low back pain. Despite being told fusion was her only option, Julie's story proves otherwise. Join us as we explore the possib...
Navigating Sciatica: Effective Treatments and Misconceptions (AKA no fusion for a herniated disc)
Просмотров 2 тыс.9 месяцев назад
Meet Chris, a ski instructor and designer builder living in a scenic New Mexico ski town. He's battled sciatica for six months, stemming from an L3/4 herniated disc that coincided with his shoulder surgery recovery. Despite his rural setting limiting doctor options, Chris persisted in seeking help. In our interview, we delve into L3/4 disc herniation, sciatica, and it's appropriate treatments. ...
How discs bulge, tear, herniate and then irritates a nerve root to cause sciatica | Best Practice
Просмотров 7269 месяцев назад
If YOU have a question you would like answered fill in the question submission form at: BestPracticeHealth.tv We get you answers!
Setting the record for bogus treatments for Severe Stenosis: How Tom found the right path.
Просмотров 4,2 тыс.9 месяцев назад
Join us for a crucial and eye-opening interview with Thomas P., who has been grappling with severe stenosis at L4/5 since early in the pandemic in 2020. Tom's journey is a testament to the challenges many face when seeking the right treatment for this very common condition. Tom's ordeal began during the COVID lockdown in 2020 when he started experiencing excruciating pain down his right leg whi...
From Femoral Nerve Injury during knee replacement to Niagara Falls Triumph: Pam's Remarkable Journey
Просмотров 6249 месяцев назад
Prepare to be inspired! I know I was. Join me for a heartwarming interview with Pam W., whose life took a dramatic turn thanks to a proper diagnosis and determined spirit. A few months ago, Pam appeared on BestPracticeHealth.tv, sharing her struggle with a femoral nerve injury that resulted from a knee replacement surgery, where a tourniquet was applied for too long. The effects left her barely...
After years of chronic neck pain Sandra got the use of her hands back with ACDF surgery | Follow up
Просмотров 1,2 тыс.10 месяцев назад
I had the pleasure of catching up with Sandra Bagwell, a resilient Texas goat rancher, who shared her remarkable journey. We first met several months ago when she described her condition to me on a call in show. Sandra was barely able to function, yet alone take care of her ranching duties. My, how things have changed. Sandra welcomed over 40 newborn goats into her herd this year, but it's her ...
Understanding Vascular Claudication in Spinal Stenosis | It's Not Always Neurogenic!
Просмотров 3 тыс.10 месяцев назад
Did you know that not all claudication in spinal stenosis is neurogenic? If you or someone you know is dealing with spinal stenosis, this video is a must-watch! In this informative and eye-opening interview, we dive deep into the world of vascular claudication and how it confused by this man's doctors as neurogenic claudication due to spinal stenosis. We break down the key difference, namely th...
Her 8-month Struggle with a Herniated Disc: Navigating a Broken Healthcare System
Просмотров 3,6 тыс.10 месяцев назад
Have you ever felt lost in the labyrinth of healthcare bureaucracy? This powerful interview is a stark reminder that we must be our own advocates in today's complex healthcare landscape. In this emotionally charged conversation, we sit down with a resilient young woman who faced a harrowing eight-month journey with a large herniated disc while battling insurance company denials and misinformed ...
Cracking the Code: Hip Pain due to arthritis or Low Back Pain? Unraveling the Mystery
Просмотров 2,5 тыс.11 месяцев назад
Is it your hip or your back causing the pain? The answer might not be as straightforward as you think! Join us for an enlightening interview with a young lady who discovered her back pain was actually stemming from her hip. In this in-depth conversation, we sit down with a young lady to explore her journey of misdiagnosis and finally finding relief. She'll share her experiences and insights on ...
How a woman is navigating the Giant Herniated Disc Dilemma: Surgery vs. more Conservative Treatment
Просмотров 2,3 тыс.11 месяцев назад
Are you facing the daunting decision of whether to undergo surgery for your giant herniated disc? In this enlightening interview, we sit down with a woman trying to avoid surgery to unravel the complexities of this challenging choice. Join us as she shares her journey and insights on managing a giant herniated disc without rushing into surgery. We'll delve into the intricacies of using MRI imag...
Understanding Back Pain: Why RFA Failed After Medial Branch Block and what to do next.
Просмотров 6 тыс.11 месяцев назад
In this enlightening interview, I sat down with Elliot May to delve into his journey of dealing with persistent back pain. Elliot's story is not uncommon; after experiencing relief from a diagnostic medial branch block, he had high hopes for Radiofrequency Ablation (RFA) to provide lasting relief. However, RFA didn't work as expected, leaving him in the 40% of patients who don't experience the ...
Doctor is wrong about back surgery: you may have neuropathy!
Просмотров 1,9 тыс.11 месяцев назад
Doctor is wrong about back surgery: you may have neuropathy!
All tests are negative, what's wrong with my knee? | Best Practice
Просмотров 235Год назад
All tests are negative, what's wrong with my knee? | Best Practice
Doctor, do you recommend ketamine infusion for people on chronic narcotics for musculoskeletal pain?
Просмотров 177Год назад
Doctor, do you recommend ketamine infusion for people on chronic narcotics for musculoskeletal pain?
It's been six months and I still don't know what the MRI shows. Help! | Best Practice
Просмотров 991Год назад
It's been six months and I still don't know what the MRI shows. Help! | Best Practice
Methods of denervation for endoscopic dorsal ramus rhizotomy Doctor describes | Best Practice
Просмотров 214Год назад
Methods of denervation for endoscopic dorsal ramus rhizotomy Doctor describes | Best Practice
"Just wanted to let you all know how great low back fusion is working for me!" | Patient comment
Просмотров 1,1 тыс.Год назад
"Just wanted to let you all know how great low back fusion is working for me!" | Patient comment
"RFA works great for neck pain. But can it also help my migraine?" Doctor answers | Best Practice
Просмотров 173Год назад
"RFA works great for neck pain. But can it also help my migraine?" Doctor answers | Best Practice
"CBD is good for joint pain. But will it turn my face red like alcohol does?" NO! | Doctor answers
Просмотров 257Год назад
"CBD is good for joint pain. But will it turn my face red like alcohol does?" NO! | Doctor answers
Spinal stenosis but I"m only 54! What's next? | Viewer question
Просмотров 847Год назад
Spinal stenosis but I"m only 54! What's next? | Viewer question
Acute low back pain for 2 weeks after lifting. Doctors discusses when to see doctor | Best Practice
Просмотров 591Год назад
Acute low back pain for 2 weeks after lifting. Doctors discusses when to see doctor | Best Practice
I've had a herniated disc for 9 years and I'm 21 years old!!! | Viewer question
Просмотров 1 тыс.Год назад
I've had a herniated disc for 9 years and I'm 21 years old!!! | Viewer question
Is ketamine the next step in overcoming your chronic pain? Doctor discusses| Scoliosis
Просмотров 1,5 тыс.Год назад
Is ketamine the next step in overcoming your chronic pain? Doctor discusses| Scoliosis
"You mean the only treatment they didn't do was the one you needed? | Low back pain
Просмотров 1,5 тыс.Год назад
"You mean the only treatment they didn't do was the one you needed? | Low back pain
Outdoorsman, hunter, grown up girl dad: "Do I have to have surgery?" | Herniated disc with sciatica
Просмотров 3,1 тыс.Год назад
Outdoorsman, hunter, grown up girl dad: "Do I have to have surgery?" | Herniated disc with sciatica
Biker with neck pain who needs a surgery he doesn't want | Cervical radiculopathy
Просмотров 476Год назад
Biker with neck pain who needs a surgery he doesn't want | Cervical radiculopathy
Severe leg pain after helping a senior citizen stand | Far Lateral Herniated Disc Herniation
Просмотров 2 тыс.Год назад
Severe leg pain after helping a senior citizen stand | Far Lateral Herniated Disc Herniation
A hairstylist from LA with a lifetime of back pain and when to AVOID fusion | scoliosis
Просмотров 753Год назад
A hairstylist from LA with a lifetime of back pain and when to AVOID fusion | scoliosis

Комментарии

  • @ruhtardedninjas
    @ruhtardedninjas 22 часа назад

    Okay I had my microdiscectomy 15 days ago, I felt GREAT for about two weeks but now all of a sudden I’m starting to feel it coming back again. I feel the pain mainly in my left hip/buttocks but I’m still positive for the slumped leg raise. Have I re-herniated?

  • @ramonaarnold4917
    @ramonaarnold4917 День назад

    Are you familiar with the Ultrasonic Spine surgery (Laminaplasty) MIS. I'm getting an MRI July 15. I already know I have spinal stenosis, degenerative disc disease from MRI 2 yrs ago and possible neurogenic claudication in legs. I'm a 70 yr old female and DO NOT want a fusion. How do I get my MRI to you? I am Considering the Mayo Clinic in Minnesota if I'm not happy with the Dr I will be seeing. I live in Fargo, ND. Thank you! I love your videos😊 Mona A.

  • @BeatlesFanSonia
    @BeatlesFanSonia День назад

    Music is too loud. I had difficulty hearing the doctor !

  • @fernandomartinez5397
    @fernandomartinez5397 День назад

    Hi, I have 2 bulging discs with large annular tears causing bilateral foraminal stenosis at L4-L5 and L5-S1. My surgeons is recommending a two-level laminectomy. The vast majority of my pain is in my lower back, and I start getting debilitating spasms if I stand or walk for too long. Would the laminectomy be a good option?

  • @howardrobinson4938
    @howardrobinson4938 День назад

    "I haven't done surgery in five years." Retired? Seems I recall in previous videos that you've been shy to fusions and here you're taking the pro fusion position. What gives?

  • @user-vv2ll2hm7u
    @user-vv2ll2hm7u День назад

    Help, my lower back is killing me to the point of being hard to walk , bend or anything, it’s a burning pain center that radiates left n right n down

  • @khawlaelayyan4942
    @khawlaelayyan4942 День назад

    Hi dr ,my daughter had olif surgery for isthmic spondylolisthesis l5s1 she suffered from neurological claudication in her left leg .now it's been one and half year and still can't walk more than 10 minutes because she has a heavy leg .so what do you think

  • @bondjane007
    @bondjane007 День назад

    Please tell me why right after my BOTCHED nerve abrasion of my neck I now have constant pain & can't look up anymore? What went wrong? I do know I didn't have any anastitic because I had had some milk in my coffee that morning, but I had heard people did it without any pain meds. & it wasn't that painful. Well I decided to do that. It was ever so painful. I was screaming & writhing in pain. So they decided to stop & not do the other side. I think I came back a week or so later & they did both sides meaning they did the same side 2 times. I think they should have not done that. I believe that is why I now have pain I never ever hand in my neck. My neck pain was very little & only sometimes. Much like a morning stiff neck sometimes. But I could tilt my head back to gargle after the NA I can't!! Can U tell me what happened? A doctor I saw about my neck which is military & slightly forward, probably due to breaking my L4 some yrs. ago & maybe my ribs moved forward because I lost height, lots of height. No doctors fixed my compression fracture to regain my lost height so now my lungs have less space & maybe that is why my head is now forward & I have NO waist anymore. My ribs almost touch my hips now.. Very uncomfortable as is the 24/7 neck pain & very limited motion. I was told my bones R too thin to do any discs & I don't want my neck fixed. If that happens I will have even less movement than I now have. I am very upset about this situation. I don't understand how my bones R too fragile to have discs pit in when I had THR last year. The screws R holding up well. I even fell on concrete & nothing came apart & nothing broke.. Any thought?? I do believe something happened when I had the nerve ablation, because I didn't have the pain before & now have pain all the time in my neck.. I am sure I had military neck & forward head to some degree, & I did not have this constant neck ache & did not have any problem tilting my head back to look up or gargle.. What happened? The spine surgeon I saw said he agreed something must have gone wrong with the nerve ablation since I had no pain before the procedure & after 24/7 pain & limited movement.. Very unhappy now.. I feel my life is ruined..

  • @lizcorredor3480
    @lizcorredor3480 2 дня назад

    Why don't you just get a x-ray

  • @MrimhimmothyBetts
    @MrimhimmothyBetts 2 дня назад

    I literally just got a couple of days ago and out of knowhere pain ! When I fully bend or lift at certain angles smh . I can still , walk , jog with no pain haven’t tried running yet

  • @ayushjindal4981
    @ayushjindal4981 2 дня назад

    Mine has not healed in 5 years

  • @brians2328
    @brians2328 3 дня назад

    Anesthetic disc blocks are the most effective way to determine if the pain is caused by the disc.. I believe Dr Choll Kim is doing this before his procedures.. Also Dr Doug Beall is very skilled in advanced treatments and diagnostics....

  • @abhishekdasroy4837
    @abhishekdasroy4837 3 дня назад

    Any updates??

  • @alien2393
    @alien2393 4 дня назад

    Its been 1 year high school is hell grades have also been hit

  • @johnmitchell2741
    @johnmitchell2741 4 дня назад

    Lady you havent seen nothing yet😭

  • @johnmitchell2741
    @johnmitchell2741 4 дня назад

    Im going on ten years

  • @johnmitchell2741
    @johnmitchell2741 4 дня назад

    She sounds supper exited about your findings

  • @johnmitchell2741
    @johnmitchell2741 4 дня назад

    GOOD TIMES

  • @johnmitchell2741
    @johnmitchell2741 4 дня назад

    thanks for the video showing how to read the MRI. Unfortunatly my pain specialist wouldn't look at my MRI let alone explain it to me so I had to figure out how to open and read the MRI even though I'm not sure how to read and understand some parts

  • @johnmitchell2741
    @johnmitchell2741 4 дня назад

    When i had my latest MRI done and went to my pain specialist I gave him the radiogist and disc report of the MRI he read the report and said you have a multitude of issues with your spine according to the report. I said aren't you gonna look at the MRI I brought to you and he said no need to we will just give you some epidural shots to try and isolate where your pain is coming from. So I had the first round and it messed me up so bad I could barely drive home cause I couldn't feel my legs and for the last two weeks I haven't been able to walk more the a couple hundred yards without dying in pain. Folks be careful before letting anyone cut on you or give you an injection

  • @johnmitchell2741
    @johnmitchell2741 4 дня назад

    been there done that 2015 Surgeon said I need a fusion no disc left gave me no other options. now 9 years later I have adjacent disc dieses at L3 and L5 with a herniated disc at L5 and L4 on top of that I now have severe arthritis in my L4 facet joint because of L4 . Im in agony every day but going thru a 3rd fusion at this point is the last thing I wont to do . Im male 63 🤢🤮🥵😵

  • @johnmitchell2741
    @johnmitchell2741 4 дня назад

    if you didnt have back pain what would you be doing 🤣😂

  • @digitalaudits
    @digitalaudits 4 дня назад

    Is any hardware/titanium made in China?

  • @addison6384
    @addison6384 5 дней назад

    Some people have had this done every couple of years. My questions is, if you keep burning the nerves it would seem to me that eventually there won't be any nerves to treat. Is that the objective to completely kill the nerves?

  • @kevinpowers9024
    @kevinpowers9024 5 дней назад

    Got the HA injection today, (6-28-2024) Three cc lidocaine and 6cc synvisc one. I forgot to ask the Dr, how long till I can play golf again? A week? Two weeks?

  • @tulsibajgain1607
    @tulsibajgain1607 5 дней назад

    I have 2 years of hearniated disk pain

  • @michaelwenniger2878
    @michaelwenniger2878 5 дней назад

    Would a person be able to Golf Again ?? at a Hight Level ???

  • @jeaninerumble6503
    @jeaninerumble6503 5 дней назад

    Thank you for this helpful tutorial. The time you’ve taken to explain this is very appreciated!

  • @timothy5988
    @timothy5988 6 дней назад

    Are you even a doctor

  • @timothy5988
    @timothy5988 6 дней назад

    You are a scare tactic fraud!

  • @rayc.6704
    @rayc.6704 6 дней назад

    My inner knee hurts so bad I cannot sleep except on my left side

  • @jonpreston2634
    @jonpreston2634 6 дней назад

    Unbelievably unprofessional approach here.. clickbait titles fear fear-mongering and taking advantage of the fact that people just got a diagnosis and don't know what to do... you are a parasite.

  • @khosomujeeb
    @khosomujeeb 6 дней назад

    Anyone who just got knee inflammation (lasted for 4 days ) and muscles cramps in knee area without any other reason . Just knee sprain without any other reason.

  • @despoullapantelaki2479
    @despoullapantelaki2479 6 дней назад

    I hope my question is answered and guide me through the labyrinth of information.... I have been diagnosed with Left Upper Thorasic Herniated Disc causing severe Radiculopathy... the pain is excruciating.... can this problem be surgically addressed at the spot where it it? or what kind of Injections can tackle the problem, Epidural injections or Cortisone injections? Please advice, thanking you from my heart....

  • @carolinagorodetsky8200
    @carolinagorodetsky8200 7 дней назад

    Where is the video part where you talk about if glucosamine and chrondroitine help for herniated disc? 🙂 I got it from squatting without proper warmup.

  • @noesis1230
    @noesis1230 7 дней назад

    I am 36 years old. I have Bilateral L5/S1 Herniations. I got bilateral TFESIs about a month and a half ago. I have had manageable pain until the other day. And, this morning, I woke up at screaming, and instantly alert in excruciating pain. Have laid in bed all day. Pain radiating to the front and even in the groin right now. I have these issues due to an auto accident, and I am currently waiting for the paperwork to go through to get Bilateral Discetomies. I wish everyone of us dealing with these issues the best of luck. I am scared myself. And now, Im going to the ER and who knows what will happen.

  • @AnthonyBarrett-oz6po
    @AnthonyBarrett-oz6po 7 дней назад

    My left leg I cannot bend because of lumbar stenosis. I find my self in bed mostly because of the pain.

  • @FreeNuggetsHere-
    @FreeNuggetsHere- 7 дней назад

    I'm 26 and have moderate to severe spinal stenosis and 2 large disk bulges in my lower back and I've been in constant pain for over 3 years 😅

  • @ZacharyHernandez-wd9bv
    @ZacharyHernandez-wd9bv 7 дней назад

    I told my doctor about my sciatica pain and i told him about Gabapentin and he said thats a strong medication 😢

  • @bigmanting5735
    @bigmanting5735 8 дней назад

    Mine only hurts when i do boxing

  • @dennistracy1535
    @dennistracy1535 8 дней назад

    stabilize, not stabalize. medical school much?

  • @DollyAkish
    @DollyAkish 8 дней назад

    Taking Midnight CBD capsules daily has reduced my anxiety. I feel much calmer and more focused throughout the day. #midnightcbd

  • @DollyAkish
    @DollyAkish 8 дней назад

    After workouts, I apply Midnight CBD cream to my sore muscles, and it works wonders! #midnightcbd

  • @sherifgendy4974
    @sherifgendy4974 8 дней назад

    you are one of the worst people who spoke about this matter. i have stenosis on C4 to C7 and its more than severe. painful yes, i am unable to do many things, but when you say the only way to beat it is to die before it gets worse is such insensitive and you should not be a medical practitioner by any given chance. stenosis has multi-factor origin either discs or joints or ..., but most of it if not causing symptoms should not be touched. if its symptomatic, then you consider non surgical options and only go to surgery when all other options are exhausted.

  • @angelenathompson744
    @angelenathompson744 8 дней назад

    Me hernated slip disc bulging disc sciatica nerve pinched inje5 one nothing work

  • @foreward100
    @foreward100 9 дней назад

    76 years of age had lumber Laminectomy and rods put in. At this time part of top thoracic spine is protruding this appears to be bottom pivot point. Now with more one spurs there is more pain and weakness in legs. Hyper extension of back gives light headed feeling. Being bent over using an rollator helps a lot but without use inhibits my walking and makes me hunched over. any suggestions are appreciated.

    • @BestPracticeHealth
      @BestPracticeHealth 9 дней назад

      It sounds like you're dealing with severe thoracic stenosis adjacent to a previously instrumented lumbar fusion, which is affecting your gait and necessitating the use of a walker. Severe stenosis next to a lumbar fusion can often be treated with a laminectomy (decompression) of the narrowed area. Most surgeons would recommend extending the previous fusion to include the newly decompressed level. While this is a significant surgical procedure, there is an alternative option that might be less invasive. A minimally invasive decompression surgery could potentially help you regain your ability to walk without a walker. I strongly recommend seeking an opinion from a spine surgeon who specializes in minimally invasive surgery to explore this option.

  • @nedimduman2484
    @nedimduman2484 9 дней назад

    was suffering for an annular tear for 4 years. Pain was groin and backpain. MRI came out with a annular tear L4/L5. Next month surgery in Istanbul

    • @BestPracticeHealth
      @BestPracticeHealth 9 дней назад

      I am so glad you got help! And wishing you pain relief and a quick recovery from surgery!

    • @brians2328
      @brians2328 3 дня назад

      Same.. I went to Germany 🇩🇪 2 level ADR Lp-Esp 💪 .. What procedure are they offering in Turkey?

    • @nedimduman2484
      @nedimduman2484 2 дня назад

      @@brians2328I am going to do annulair tear surgery, a laser discectomy, my disc is fine but there is a tear in it thats causing pain. Probably in the future (10-20) years a disc replacement. How are the new discs?

  • @Footballwithbikku
    @Footballwithbikku 9 дней назад

    Hello doctor can I get heal from mild disc Bulge by doing core exercises

    • @BestPracticeHealth
      @BestPracticeHealth 9 дней назад

      A disc bulges when it is unable to absorb the load at its level. While you can't change the structure of your discs, ligaments, bones, or tendons, you can significantly influence your muscles. Muscles play a crucial role in supporting the spine, and by strengthening your core, you can theoretically offload some of the stress from a bulging disc, providing it with additional support. Although there may not be definitive scientific proof of this, it makes common sense and aligns with clinical observations. I've seen many individuals experience reduced back pain as they improved their core strength and overall muscle condition.

  • @DD-rt9lc
    @DD-rt9lc 10 дней назад

    Rather death than Spondylitis. Peaple do not realise how hard life can get.

    • @BestPracticeHealth
      @BestPracticeHealth 9 дней назад

      Thank you for your comment. Please know that you are not alone. No matter how challenging life gets, we can rely on each other to make it more pleasant and bearable. You are not alone. I hope you have a good doctor to provide advice. I hope you are surrounded by family and friends to hold you up when you are feeling down. Take time to refresh yourself in nature and seek out things that make you laugh. My best wishes and hope go out to you. Remember, no matter how tough life can get, death is rarely the answer.

    • @DD-rt9lc
      @DD-rt9lc 8 дней назад

      @@BestPracticeHealth thank you for your kind words. I dont have anything positive to say. But thank you for you.

  • @williamzirkle3481
    @williamzirkle3481 10 дней назад

    I had total reverse shoulder surgery in February 2024, had several weeks of PT and went back to work in May 13. Little over 3 months but can do my job with a little fine tuning...the job is the same. The way I do it it changed. Some muscle pain but just from working the muscles back into shape. It was 100% successful.

    • @BestPracticeHealth
      @BestPracticeHealth 9 дней назад

      Thank you so much for your comment. The internet is indeed filled with horror stories about total shoulder replacement. In the early days of this operation, many orthopedic surgeons were still learning how to use reverse implants effectively, especially in patients with rotator cuff tears. Fortunately, the outcomes of total shoulder replacement today are much better than their reputation might suggest. I'm glad to hear that you are back to work and doing well.