Treating Diabetes with Acupuncture and Oriental Medicine

Reprinted from our June Newsletter here:  http://www.acunut.com/files/June_2011.pdf

It is estimated that 25.8 million men, women and children in the United States have diabetes. Diabetes is a disease in which the body does not produce or properly use insulin, a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. According to the Centers for Disease Control and Prevention the risk for death is approximately twice that of persons of similar age without diabetes.

The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles. Complications of diabetes include heart disease, hypertension, eye problems, kidney disease, nervous system disease, periodontal disease, amputation, fatigue, depression, and complications during pregnancy.

In order to manage diabetes, it is essential for people to make healthy lifestyle choices in diet, exercise, and other health habits. Another important factor when treating diabetes is creating a support team of health care professionals. This support team may include your primary doctor, an eye doctor, nurses, a dietitian, and a licensed acupuncturist.

Diabetes according to Oriental Medicine
According to Traditional Oriental Medicine, diabetes is caused by an imbalance of the cyclical flow of Qi within the meridians and organ systems.
This particular imbalance produces heat that depletes the body’s fluids and Qi causing symptoms such as:  
Fatigue
Lethargy
Unexplained Weight Loss
Excessive Thirst (Polydipsia)
Excessive Urination (Polyuria)
Excessive Eating (Polyphagia)
Poor Wound Healing
Infections
Irritability
Blurry Vision

How Acupuncture and Oriental Medicine Treats Diabetes
In treating diabetes, Oriental medicine offers a way to address each patient individually to eliminate the symptoms associated with diabetes and reduce the need for insulin. A variety of techniques may be used during treatment including acupuncture, herbal medicine, bodywork, lifestyle/dietary recommendations and energetic exercises. The treatment for diabetes focuses on regulating the circulation of blood and Qi and balancing the organ systems to improve pancreatic function and address internal heat and the depletion of fluids. When treating diabetes, acupuncture and Oriental medicine can assist the body to regain its normal healthy functioning.
There are a lot of complications caused by diabetes that require extra attention. If you have diabetes make sure you monitor these five areas on a regular basis.

Blood Sugar: Understand how diabetes changes how food affects your body. Know the signs of low blood sugar. Have a plan in place to correct your blood sugar levels when necessary.

Heart Health: Diabetics have a higher risk of heart attacks and stroke. Optimal cholesterol and blood pressure goals are lower for diabetics.

Infections: Due to higher blood sugar levels bacteria grow and infections develop more quickly. Treating infections early on can prevent serious complications later. 

Feet: Diabetics may suffer from neuropathy, or nerve death in their feet and can get an injury or serious infection without feeling it.

Exercise: Exercise has been shown to decrease blood sugars and improve insulin resistance, the main issue in those with type II diabetes.

 To add acupuncture and Oriental medicine to your arsenal when fighting diabetes and learn more about how acupuncture and Oriental medicine can improve your health and well being call for a consultation today!

THE FIRST ORDER OF QI CULTIVATION – DIET

Ok, so in order for food to have qi or vital energy in it, it must look at least a little like how it looked in nature. NO, protein bars and energy powders do not count. By the time many folks are desperate enough to try acupuncture, many of them are literally starving to death. This is not just dramatic license on my part! Proper nutrition is more than minimizing carbs, or the proper combination of vitamins and minerals. Many people go months or years without eating a single living thing.

How may servings per day?

The USDA recommends a daily serving of 4-5 vegetables and 2-4 fruit to meet our basic nutritional requirements. OK, that 9-10. Most of us are lucky to get one or two. But in order for the body to heal, there must be a surplus of qi and nutritional building blocks. Since food is how we provide the body with the building blocks needed for cellular processes including repair, missing even a few micronutrients can play make healing much more difficult. So begin to support the healing process by enjoying a balance of fresh foods that are in season. Please note that fresh does not necessarily mean raw. Many of us have digestion so compromised that even if we ate all those raw fruits and veggies, they would not be absorbed properly anyway. Fresh vegetables that are lightly steamed (not boiled to death) have plenty of qi and vitality in them, and are more easily assimilated by the body.



“You will be assimilated”

For those of you who may not understand what I mean by “assimilated” I find it helpful to remember the Borg in certain Star Trek episodes. It is the job of the body to absorb and process all the nutrients available in the foods that we eat. But how well the body is able to do that depends upon 1) the quality of the food we are eating and 2) our own ability to actually take in that nutrition. Our ability to absorb butrients from the foods that we eat decreases as we get older, and is affected by other helath conditions. Smoking dramatically decreases how well we absorb nutrients; individuals who are immuno-comprimised, suffering from chornic disease, or or undergoing chemotherapy or HAART find that their medications can damage the lining of the stomach and intestine so that it is more difficult to digest food.

Second, I think it is helpful to be realistic about diet: it is difficult, if not impossible to get everything we need from diet without a lot of work (e.g. shopping, chopping, scrubbing, cooking, chewing…Oy vey). Save yourself some anguish and find a good multi-vitamin, with additional herbs or supplements as needed. When determining which supplements to take, I cannot stress enough the importance (and ultimate cost savings) of working with a licensed practitioner to help determine guide you. All of us have yielded to, at one time or another, the temptation to try that one new supplement that our friend raved about thinking it might help. (Be honest, how many have an entire shelf or section of the counter devoted to various bottles, lotions, and herbal potions?) It all adds up. Secondly, for those folks who are taking a large number of western medications, indivisuals who are immuno-comprimised or undergoing chemotherapy, it is extremely important to work with someone who is competent in both eastern and western biomedicine.

Women's Health Concerns and How Acupuncture Can Help

Reprinted from our monthly newsletter...

The biggest threats to women's health are often preventable. Oriental medicine has always addressed the special needs of women throughout their lives and many health issues women face respond extremely well to acupuncture treatments. Taking small steps to improve your health can make a difference.

The top health concerns affecting women and how acupuncture can help are:

Cardiovascular Disease
As the number one threat to women's health, cardiovascular disease is not just a man's disease. In women, the condition is responsible for about 29% of deaths, reports the CDC. Although more men die of heart disease than women, females tend to be under diagnosed, often to the point that it's too late to help them once the condition is discovered. By integrating acupuncture and Oriental medicine into your heart healthy lifestyle, you can reduce your risk of cardiovascular disease by as much as eighty percent.


Steps to prevention include managing high blood pressure and cholesterol, quitting smoking, eating healthy, maintaining a healthy weight, physical activity, reducing stress and improved sleep - all of which can be helped with acupuncture and Oriental medicine. Acupuncture has been found to be particularly helpful in lowering blood pressure. By applying acupuncture needles at specific sites along the wrist, inside the forearm or in the leg, researchers have been able to stimulate the release of opiods, which decreases the heart's activity and its need for oxygen. This, in turn, lowers blood pressure.

Cancer
There have been many advances in the early detection and treatment of cancer. While the standard medical care for cancer is effective, the treatments are aggressive and cause numerous unwanted side effects as well as a lowered immune system. The three most common cancers among women are breast, lung and colorectal cancer. While breast cancer is the most common cancer in women it is second in the leading cause of cancer death. Early detection screenings and recommended self examinations should be taken seriously.


Acupuncture has received much attention as an adjunctive therapy in cancer treatments for its use in pain relief, reducing side effects, accelerating recovery and improving overall quality of life.



From a preventive approach Oriental medicine works to restore imbalances in the system with a variety of treatment modalities including acupuncture, herbal therapy, tui na, qi gong in addition to food, exercise and lifestyle suggestions. Seasonal acupuncture treatments just four times a year serve to tonify the inner organ systems and correct minor annoyances before they become serious problems.

Osteoporosis
Characterized by a decrease in bone mass and an increased likelihood of fractures osteoporosis is not simply a calcium deficiency. As a complex living tissue, bone is made of many different components and is influenced by many variables including the body's use of calcium from the bone to balance pH levels in the blood. Osteoporosis threatens 44 million Americans, of which 68% are women, reports the National Osteoporosis Foundation.    "Osteoporosis is largely preventable," says Mark. "The behaviors that women develop in their childhood, in their adolescence, and in their early adult years really play a significant role in the development of the disease." That's because bodies build up most of bone mass until age 30. Then new bone stops forming and the focus switches to the maintenance of old bone.

Acupuncture and Oriental medicine coupled with a healthy lifestyle and regular exercise, have much to offer in improving the quality of life for those who suffer from bone and joint problems.

Depression
Depressive disorders affect 10%-25% of women at some point in their lives. The body’s immune system is compromised and symptoms reduce functioning, impair work performance and social relationships. Common symptoms of depressive disorders include: a decreased interest in most activities, insomnia, fatigue, and feeling empty and worthless. At its worst, hopelessness sets in and suicide becomes a desperate option for approximately 15% of people who suffer from severe depressive disorders.

Oriental medicine does not view people as a collection of segmented parts to be treated independently but rather addresses the link between the body, spirit and mind. The goal of Oriental medicine is to bring all the human systems into a healthy balance, insuring that both the mind and body feel well and when used in conjunction with psychotherapy acupuncture has a positive and holistic effect on depressed patients. If you suffer from depression, consider acupuncture therapy in conjunction with your treatment plan to regain peace of mind, regulate your immune system and stay healthy.

Autoimmune Diseases

Autoimmune diseases are a group of disorders in which the immune system attacks the body and destroys or alters tissues. There are more than 80 serious chronic illnesses in this category, including lupus, multiple sclerosis, and type 1 diabetes.  According to the American Autoimmune Related Diseases Association (AARDA), about 75% of autoimmune diseases occur in women. Individually, each disease appears uncommon with the exception of diabetes, thyroid disease, and lupus however as a group, the disorders make up the fourth-largest cause of disability among American women.


Due to the complexity of treating autoimmune disorders, integrative medicine solutions have received much attention as successful therapies in their treatment. Acupuncture and Oriental medicine are specifically noted for use in pain relief, regulating the immune system, managing symptoms and improving overall quality of life.

Menopause and Gynecological Health
Gynecological conditions including Premenstrual Syndrome (PMS), fibroids, endometriosis, and infertility along with menopause are some of the most successfully treated problems by acupuncture and Oriental medicine. Oriental medicine has long recognized that health and vitality can be sustained over a woman's lifetime by restoring balance within the body and supporting the natural production of essential hormones.
Menopause is a transitional period marking the cessation of ovulation in a woman's body. Symptoms vary from mild to severe, and are brought on as our bodies try to adapt to decreasing amounts of estrogen. Symptoms can include hot flashes, night sweats, insomnia, fatigue, mood swings, memory loss, dryness, headaches, joint pain, and weight gain. Menopause patients are encouraged to maintain a healthy weight, stabilize blood sugar, and eliminate stress, tension and anxiety or learn new techniques to cope with them to diminish the effects they have.

Oriental medicine does not recognize menopause as one particular syndrome and aims to treat the specific symptoms that are unique to each individual using a variety of techniques such as acupuncture, herbs, bodywork, lifestyle/dietary recommendations and energetic exercises to restore imbalances found in the body. Therefore, if 10 women are treated each will receive a unique, customized treatment with different acupuncture points, different herbs and different lifestyle and diet recommendations.

With support from Acupuncture and Oriental Medicine along with small changes in lifestyle and diet, menopause can be a time of a revival of vital energy and an opportunity for personal growth

To learn more about how acupuncture and Oriental medicine can improve your health and well being call for a consultation today or contact me directly at webmaster@acunut.com.

Acupuncture for Weight Loss

In Oriental medicine the root of excess weight is an imbalance within the body caused by malfunctioning of the spleen and liver organ systems. Acupuncture points, foods and herbs selected to assist with weight loss directly influence the Qi of the spleen and liver systems to treat the imbalances causing the weight gain.

The spleen is responsible for the proper functioning of the digestive system, ensuring that the food we eat is transformed into Qi, the vital substance of life. Disharmony of the spleen will have symptoms such as fatigue, slow metabolism, water retention, loose stool, and feeling of heaviness.

The liver’s job is to keep the flow of your body’s Qi, blood and emotions running smoothly. Our modern, fast-paced lifestyle and chronic stress can negatively impact the liver’s ability to function properly and smoothly, which, in turn, can cause the spleen and the whole digestive system to function poorly and decrease your metabolism. Liver disharmony can also cause some of the “triggers” that lead to cravings and compulsive eating.


Acupuncture and Oriental medicine has been shown to have an effect on the functioning of the nervous, endocrine and digestive systems, food cravings, and metabolism. These functions all help energize the body, maximize the absorption of nutrients, regulate elimination, control overeating, suppress the appetite, and reduce anxiety.

A Total Health Program
Acupuncture and Oriental medicine address the issues of over-eating and low metabolism with effective tools to control appetite and increase energy. Energetic imbalances are corrected and the digestive and elimination processes are improved so that there is a physical shift in the body to naturally have more energy and desire less food. By addressing both the physiological and psychological aspects of weight loss acupuncture and Oriental medicine provide a comprehensive therapy for weight issues that promotes better digestion, smooths emotions, reduces appetite, improves metabolism, and eliminates food cravings.

Each treatment is catered to the needs of the individual patient. Acupuncture points on the body are chosen for overall well being with the objective of increasing circulation of the blood and Qi (stimulating the metabolism) and calming the nervous system. Treatments can include a combination of auricular (ear) and body acupuncture, ear tacks or pellets to leave on in-between treatments, herbs and supplements, abdominal massage, breathing exercises, and food and lifestyle recommendations.

In addition to treating the root of the imbalance within the body, different acupuncture points may be chosen for each treatment as different symptoms arise. For instance, if you are experiencing a desire to overeat related to premenstrual syndrome (PMS) one week, then that can be addressed at that week’s appointment.

The herbs and foods that are chosen during a weight loss treatment are for promoting healthy digestion, energizing the body, augmenting Qi, and improve elimination of water, toxins, and waste products. Most patients report a marked decline in appetite and cravings with acupuncture alone but herbs, healing foods, and exercises can definitely enhance the efficacy of the treatments.

Blueberry-Lemon Sorbet
A healthy antioxidant rich treat at only 77 calories per 1/2 cup serving.
3 cups blueberries
1/2 cup water
2 T honey
1 t lemon zest
2 T fresh lemon juice
1/8 t salt
Place all ingredients in a blender and process until smooth.  Pour into a freezer safe container.  Freeze 1 hour or until hard.
Let stand 10 minutes before serving.

Source: Health, 2006


Come in for a consultation to see how acupuncture and Oriental medicine can assist you with your weight management goals and help you to live a long, healthy life!

Reprinted from our April Newsletter at http://www.acunut.com/files/April_Newsletter_-.htm

I (Heart) the Heart

February is the American Heart Association's Heart Health Awareness Month, emphasizing the dangers of heart disease and the importance of heart health. Heart disease includes conditions affecting the heart, such as coronary heart disease, heart attacks, congestive heart failure, and congenital heart disease. Despite dramatic medical advances over the past fifty years, heart disease remains a leading cause of death globally and the number one cause of death in the United States. By integrating acupuncture and Oriental medicine into your heart healthy lifestyle, you can dramatically reduce your risk of heart disease.


Taking small steps to improve your health can reduce your risk for heart disease by as much as eighty percent. Steps to prevention include managing high blood pressure, quitting smoking, maintaining a healthy weight, reducing stress and improved sleep - all of which can be helped with acupuncture.

1. Manage High Blood Pressure
High blood pressure makes the heart work harder, increasing its oxygen demands and contributing to angina. This excessive pressure can lead to an enlarged heart (cardiomegaly), as well as damage to blood vessels in the kidneys and brain. It increases the risk of heart attacks, stroke and kidney disease.

Acupuncture has been found to be particularly helpful in lowering blood pressure. By applying acupuncture needles at specific sites along the wrist, inside the forearm or in the leg, researchers at the Susan Samueli Center for Integrative Medicine at the University of California, Irvine, were able to stimulate the release of opioids, which decreases the heart's activity and thus its need for oxygen. This, in turn, lowers blood pressure.
2. Quit Smoking
Most people associate cigarette smoking with breathing problems and lung cancer. But did you know that smoking is also a major cause of coronary artery disease? In fact, about twenty percent of all deaths from heart disease are directly related to cigarette smoking.

Acupuncture has shown to be an effective treatment for smoking. Acupuncture treatments for smoking cessation focus on jitters, cravings, irritability, and restlessness; symptoms that people commonly complain about when they quit. It also aids in relaxation and detoxification.

3. Maintain a Healthy Weight
Obesity is associated with diabetes, high blood pressure and coronary artery disease, all of which increase the risk of developing heart disease, but studies have shown that excess body weight itself (and not just the associated medical conditions) can also lead to heart failure. Even if you are entirely healthy otherwise, being overweight still places you at a greater risk of developing heart failure.
Acupuncture and Oriental Medicine are an excellent adjunctive tool when it comes to losing weight. They can help to energize the body, maximize the absorption of nutrients, regulate elimination, control overeating, suppress the appetite, and reduce anxiety.

4. Reduce Stress
Stress is a normal part of life. But if left unmanaged, stress can lead to emotional, psychological, and even physical problems, including heart disease, high blood pressure, chest pains, or irregular heart beats. Medical researchers aren't sure exactly how stress increases the risk of heart disease. Stress itself might be a risk factor, or it could be that high levels of stress make other risk factors worse. For example, if you are under stress, your blood pressure goes up, you may overeat, you may exercise less, and you may be more likely to smoke.

Numerous studies have demonstrated the substantial benefits of acupuncture in the treatment of stress, anxiety and mental health. In addition to acupuncture, Oriental medicine offers a whole gamut of tools and techniques that can be integrated into your life to keep stress in check. These tools include Tui Na, Qi Gong exercises, herbal medicine, dietary therapy, meditations and acupressure that you can administer at home.

5. Improve Sleep
Poor sleep has been linked with high blood pressure, atherosclerosis, heart failure, heart attacks, stroke, diabetes, and obesity. Researchers have shown that getting at least eight hours of sleep is needed for good heart health and getting less than eight hours of sleep can put you at a greater risk for developing heart disease.
Acupuncture has shown great success treating a wide array of sleep problems without any of the side effects of prescription or over-the-counter sleep aids. The acupuncture treatments for problems sleeping focus on the root disharmony within the body that is causing the insomnia. Therefore, those who use acupuncture for insomnia achieve not only better sleep, but also an overall improvement of physical and mental health.

Come in for a consultation during Heart Health Awareness Month to see how acupuncture and Oriental medicine can assist you with your heart health and help you to live a longer, healthy life.   Reprinted from our February Newsletter here.

As Above, So below…

This week my back fell apart, and for many of my patients their bodies fell apart (inexplicably for most).  And for hundreds of thousands of people in Haiti on Tuesday night, their entire world fell apart. 

I have, after having literally thousands of patient visits, become used to the way our bodies mirror the changes taking place on the planet, and the way many of my clients are tuned in to SOMETHING happening even before it does.  For many over the last few weeks, sleep has been poor, feelings of impatient and anxiety “climbing the walls” and the desire to hunker down at home have been common.  The spine  and digestion seem to be the big winners in our physical radar for something shifting massively on the planet over the last week. 

While separated by thousands of miles we are not separated from the people in Haiti.  Even if you don’t subscribe to the quantum physics piece that we are all connected at the atomic and energetic levels, we still connected as members of the human family.  So an entire country in ruins, the loss and grief of thousands of souls transitioning affects our collective family even if you don’t believe in energy of any kind. 

Hold them in your thoughts, keep sending positive energy and if you can send some money.  Thoughts are real, they have energy and intent, and if one soul is soothed by you holding them with love and good will then that will service be indeed.  Often we will not know the effects that our prayers or good thoughts have in the collective but I believe in that power nevertheless.

As the ground stops shaking and the recovery begins, our bodies will again find their center, although true north will be forever changed by what has transpired this week.  Certain eastern traditions teach us that when this many souls agree to transition together, a tremendous space in opened for all of humanity, for a paradigm shift in the heart of some kind.  I have seent his now with 9/11, Katrina, the tsunami.  We won’t know the nature of that shift for some time – a massive letting go.  Watch your dreams – are you dreaming at night of old friends, family, lovers, boyfriends, girlfriends?  Any unfinished business being wrapped up?  This is the energetic equivalent of a warm reboot and your relationship to everything that has happened in the past, your energetic and emotional relationship to all things will be shifted on some level.  You may just feel a sense of release or letting go, a sense of peace for that friend or your ex for whom there was some left over stuff. This may be followed by pain and discomfort in the thoracic spine (over the heart region), crying unexpectedly or feeling moved to tears, or pain in the low back and hips (root chakra or family - how we ground into the earth has moved).

Let us be grateful for the souls in Haiti who agreed to hold this space for us to continue our growth process, and perhaps now a measure of peace and healing can finally come to this tiny nation who has continued to survive while in the midst of tremendous corruption and so little support. 

Resolutions Schmesolutions (1/06/2010)

See if you can pronounce that 5 times fast.

Now well into the second week of the new year and not having written a word for well over a month may not be a good start to the new year.  Wanting to explore the idea of new years resolutions about health and how to make them palatable.  Did you know that for 7/10 people include weight loss and exercise and other health related items as part of their new years resolutions?  I am certainly no exception (although I did have a couple of golden years right before I went into private practice where I sort of gave up the ghost on that). 

But what to do when you don’t like veggies, are gluten free and (this one generously donated by the mother of one of my Mexican friends) thus will never enjoy connubial bliss due to my lack in the culinary area, particularly my inability to make (or eat for that matter) tortillas or tamales. 

I have always included health-related things as part of my new years resolutions, usually something like I will exercise more, take more yoga classes, lose the last 8 pounds of the 35 I put on my first couple years of practice, and the piece de resistance, run a half marathon (my secret desire to no longer look like a shar-pei in a bikini).  Forget about the fact that running is torture.  Plain and simple, work.  Not fun. No play,  No way.  (Not like tennis which has all sorts of opportunities for bullet-like profanity and hitting things with a resounding smack).

And what about my resolution to actually learn how to cook?  Smitten as I’m sure thousands are by Julie/Julia, and infatuated with the idea of actually figuring out how to make Beef Bourguignon and that in this was might secure lasting happiness of the culinary kind, how does 4 pounds of butter weekly and TONS of cow coincide with my health?  And let’s not forget the fact that as a reformed vegetarian, I never quite got the meat thing down. I am 0/5 with meat dishes for my friends, now relegated to salads and appetizers like cream cheese stuffed in salami or whatever will sit on a Ritz.   Add to that a near obsession for researching new trends in nutrition and Joel Fuhrman’s humorless assertion that we should all be strict vegans, with not even olive oil to keep us company (Eat to Live). [Brrr, it's cold in that oil-free world].

Well, I began my journey into the notion of cooking SOMETHING by going to the bookstore and actually looking at Julia Child’s book, and I am happy to say that it looks like my 1963 Edition of Stryer (Biochem) and pretty much reads like my Pchem text.  And who Knew her Beef Bourguignon used BACON (she lost me right there).   Happily, this puts to rest my brief infatuation of cooking a la Julia, (and hosting Texas hold em nights with lovely French food).  My thighs are thanking me already and I truly believe this was the intervention of a higher power.  (Now if only I can break up with cheese).

Strangely enough though, it has brought me back into the kitchen, and I realize belatedly that while my culinary skills are lacking  in the animal department, I have a certain talent for vegetables.  You see (and I am outing myself to patients here) I really don’t like them very much.  (I know – shock and betrayal)   I am a meat and potatoes girl at heart (sadly having given up any wheat laced pasta long ago).  But since one of my resolutions is to move to a more plant based diet, which includes wholesome foods that I actually COOK (note to readers:  my specialty to date is salad.  I KNOW, but really great salads).  And I am discovering that I have a certain talent for disguising vegetables so that they don’t really seem so much like vegetables (we can thank my travels in Italy– and no I do not mean they are covered in red tomato sauce ala the Cowboy curry my ex used to make (don’t ask). 

So how do we make our new year's resolutions palatable?  Regardless of our resolutions, they have to be pleasurable on some level, tasty, playful, a joy, or we just won’t do them.  So whether yours is to spend 1-2 days a week walking more, or not eating junk food, or visiting your acupuncturist more (wink),  or not getting angry over things you cannot control (#5 on my list),  they need to be realistic, kind (to ourselves and others – I mean it just would not do to abandon the family nightly to hang with the personal trainer) and fun.  We spend enough time “should-ing” ourselves as it is. 

So tonight, I made a large pot of broccoli soup, and sautéed a bunch of veggies in lemon and cilantro with parmesan to have over greens I grew in my community garden.  It was good day,  and already that’s better than anything I did last year in the kitchen.   (OK if you think about it I have no where to go but up].  Maybe that’s my theme – for most of us, pick on or two small things – walk 10 minutes a day, go to bed 30 minutes earlier, get body work once a month.  These are doable, and will build on themselves.

And hopefully by the end of the year we will be able to button out trousers while standing up...