How Holiday Overeating Affects Your Digestion

December 01, 2011

Around the holidays, we definitely change our eating patterns – and by that, I mean we typically eat a lot more! It’s during this time that there are frequent trips to the emergency room and the doctor’s office with stomach complaints. How do you know if the pains and symptoms you are having are normal? After all, as we get older, digestion does slow down and problems can occur. To understand what is normal and what is not normal, let’s review the digestive process.

How the System Works

Do you remember the GI system from health class in high school? The teacher probably told you to think of the stomach as a food processor. That’s the basic gist. The digestive system is essentially one large tube that breaks down food. And it is a pretty long - over 30 feet if you stretched it out!

Digestion starts in our mouth; from there, food particles move down our esophagus into our stomach and then to the small intestine; they’re then off to the large intestine, and finally they are pushed out from our rectum. Along the way, organs such as the liver, the gallbladder, and the pancreas get into the act, helping with digestion.  

Each organ plays a different role, so there’s potential breakdown in the process at every step. And truthfully, aging can cause some problems along the way. And eating a lot more during the holidays and different types of foods can make things worse!

Bad Eating Habits During the Holidays

We tend to eat more quickly at parties, not always chewing food properly because we’re talking and being social. Poorly chewed food can cause problems farther down – literally.

Remember that it is through contractions that food is propelled down into the stomach. Most people don’t realize that the esophagus is actually made of muscle. As we approach middle age and beyond, the muscles get weaker, the contractions are also not as powerful, and food moves more slowly through the esophagus. That can result in food particles getting stuck, especially if we’re eating a lot, eating quickly and trying new foods.

Getting Gassy After Meals

Have you been belching lately after all those holiday parties? It is caused by swallowing too much air. “Don’t we normally do that?” you may ask. Actually we don’t. Air is supposed to go down our windpipe not down our esophagus into the stomach. So belching is not normal, although it is not serious. We do it more often as we age because we might have dentures that don’t fit properly, or we may not chew our food as well as we should since we’re talking while eating. Some other causes include drinking carbonated beverages quickly – including that celebratory champagne!   

Been getting gas after all those appetizers? What’s the cause? Gas is created through the breakdown of bacteria in our intestines and expelled through our rectum. Some bacteria release a gas when being digested. Don’t panic. It’s all normal.  

Overeating and Constipation

We all get constipated, don’t we?  It’s pretty common, affecting over 50 million people a year. And as we get older, it’s more common, and seems to be more noticeable around the Thanksgiving and Christmas holidays.  

What do I mean by constipation? Seems like a simple question but is it?! After all, do we know how many bowel movements a day or week is normal? Actually, we do. Constipation is defined as having a bowel movement fewer than three times per week.

I must tell you – half of the people that tell me they are constipated actually are not! Some people think they are constipated if they do not have a bowel movement every day. However, you don’t need to make a daily bowel movement.  The number of bowel movements you make is determined by how much you eat, what you eat, and how active you are. As long as you’re making a bowel movement three to four times a week, you’re fine. Constipation is almost always temporary. If constipation continues off/on for three months, it is definitely not normal.

When is Diarrhea Normal?

Now let’s move to the opposite of constipation - diarrhea. Diarrhea is loose, watery, and frequent stool. By definition, a person with diarrhea typically passes stool more than three times a day. Along with diarrhea, we often experience cramping and bloating and sometimes nausea.

Most diarrhea lasts only a couple of days. And getting an episode of diarrhea is normal – and it happens at every age.  It’s usually caused by stomach flu or can be from food poisoning.  Diarrhea is usually mild and goes away quickly without complications.  If you are lactose intolerant and drink milk or eat cheese, you likely will get diarrhea – but you probably already know that! At holiday parties where you don’t prepare the food, it’s easy to eat something that doesn’t agree with you. There are some circumstances where diarrhea is dangerous and not considered normal such as blood in stools or intense chronic belly pain.

Worried about an Ulcer?

Concerned about an ulcer? Would you believe that a bacterial infection in our stomach actually can cause an ulcer? When it gets into the stomach, it helps to destroy the protective layer, thus causing an ulcer to develop.

How do you know if you might have an ulcer? Typically you have symptoms. Ulcers can cause gnawing, burning pain in the upper abdomen. These symptoms frequently occur several hours following a meal. The burning sensation can also occur during the night - many patients tell me they cannot sleep it’s so intense. Still others say they are always hungry or that food feels like it is getting stuck in their throat.  Every now and then, someone notices black stools. None of these symptoms are normal. I see a lot more symptoms of ulcers during the holidays – some of it is stress-related and sometimes spicy food is causing the problem. Treatment of ulcers is pretty straightforward, so don’t delay in seeing the doctor.

Like the saying goes, the holidays are a time to “eat, drink, and be merry.” All that eating, drinking, and merriment can cause problems though, so learn what’s normal and what’s not when you start to experience some GI problems.

Got other symptoms you're concerned about? Check out Is This Normal? The Essential Guide to Aging and Beyond.

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Are Frequent Bathroom Breaks Normal at My Age?

October 31, 2011

It’s one of the most common and embarrassing problems for many of us as we get older– keeping control of our urine output. Other than sex, it seems like urination is the topic most people don’t want to talk about when they come to the doctor. As we age, it’s normal to have some problems urinating, but those problems are probably not what you think. Because few people talk about it, patients often do not realize what is normal and what is not normal.

The process of making urine is pretty fascinating. It’s the body’s process of removing waste. Basically, urine is a liquid that is secreted by the kidneys. While traveling through the kidneys, urea, water and other waste combines to form urine.  Urine then travels through two tubes  to the bladder. The bladder is the final stop for urine before you use the bathroom to void. When the bladder becomes full and it starts to stretch, a nerve tells the brain it’s time to urinate.

What's Normal?

You might be surprised to learn that the capacity of the bladder is only one to two cups. That’s not a lot of space, and is important to keep in mind when you are having urinary problems. Age does work against us in maintaining normal bladder function. Increased age is associated with decreased bladder capacity and decreased bladder function. So as we get older, those factors are going to impact our ability to make, hold and control urine.

It’s also good to know that the normal pattern of urination is a decrease in urine output at night.  In other words, you should be voiding more times during the day rather than at night. If I asked most people, what’s considered a normal number of times to go to the bathroom a day, most people have no clue.  Some cannot even remember how many times they go a day!

So what’s the answer? When should you become concerned about the number of times you go to the bathroom? In terms of a total day, seven is the magic number – meaning it’s normal to urinate up to seven times a day.  It’s abnormal to urinate eight or more times a day.

Men vs. Women

Problems with urinating are usually thought of as a condition affecting women. That’s mostly true and in general twice as many women than men are affected. It’s partly due to their anatomy as well as the impact pregnancies have on the urinary system.

However, you’ll be surprised to learn that for some urination problems, that ratio changes as we age. Men also have problems urinating, and like women it occurs throughout their lifetime. The problems increase as men age. One doesn’t usually begin to notice problems until around age 60. By age 60, about 20 percent of men experience problems with urinating. By 85 years of age, however, the prevalence is almost 35 percent. This is not surprising since the majority of men’s urinating problems are related to benign prostatic hypertrophy (BPH).

 

No one wants to admit he/she has a problem with bladder control. So here are the questions I ask patients to determine if bladder control is normal:

• Do you have or ever had loss of urinary control?
• Do you ever leak or lose urine when you cough, laugh, or sneeze?
• How often do you have difficulty holding your urine until you can get to the bathroom?
• Do you ever use pads, tissue or cloth in your underwear to catch urine?

If you answer yes to any of those questions, you need more tests.

I’ve realized over time that it is when people get up to pee at night that they start to worry something might be wrong. Regardless of age, you should not be getting up more than twice a night to relieve your bladder. Any more often than twice a night is not normal, and requires a trip to the doctor’s office. Getting up at night to pee can indicate more serious disease such as diabetes, congestive heart failure, kidney disease, sleep apnea, or even Parkinson’s. Don’t dismiss it as a normal part of aging!

If you are having problems urinating, you are not alone. But you need to talk to your doctor! Less than half of women and less than 20 percent of men who have urinary problems ever seek care! That’s a tragedy since urinary problems significantly impact one’s quality of life. It’s associated with depression, work-related absences, and in the elderly increases the risks of accidental falls.

Want more explanations to those aging concerns? Check out "Is This Normal? The Essential Guide to Middle Age and Beyond"!

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Is Your Hearing Loss Normal?

October 17, 2011

“What did you say?” That’s a frequent question we ask as we get older. To understand how hearing changes as we age, and what’s normal and what isn’t, let’s review how the ear works. The ears may be small but they’re quite powerful!

Believe it or not, it is actually tiny hairs inside our ears that allow us to hear. The outer portion of our ear catches sounds waves and pushes them down through the auditory canal. The hairs pick up the sound waves and change them into nerve signals that the brain interprets as sound. Different groups of hair cells are responsible for high versus low frequencies. Hearing loss occurs when the tiny hairs inside the ear die or become damaged. The problem is that unlike the hair on our head, hair cells in our ears do not regrow, so hearing loss is usually permanent.

Some hearing loss is a natural part of aging; we even have a medical word for it – presbycusis.  As we get older, several things happen: the tiny bones become less flexible, our auditory nerve becomes weaker and hair cells die. All of this causes hearing loss.

At first, it’s most difficult to hear high-frequency sounds, such as someone talking. A spouse or the child of an elderly parent will often comment that the television volume is quite loud. Or typically, the wife will tell me she has to shout at her husband or repeat what she has said to get a response. (I know, I know…hearing loss isn’t the only reason some husbands do not respond) As hearing gets worse, it becomes more difficult to hear sounds at lower pitches.

It’s important to know that most hearing loss does not become noticeable until we’re in our sixties. And it typically gets worse each decade after age 60. By the time we approach age 70, nearly half of us will have some hearing loss. And age-related hearing loss is typically in both ears, not just one. As you would expect, most of the loss of hearing occurs slowly over time.  Rapid or sudden hearing loss is never normal.

Heredity plays an important part in determining whether you will develop significant hearing loss. So if your parents and grandparents had hearing problems, you will be more likely to as well.

There are some other risk factors for hearing loss. If you had jobs where there was a lot of noise, you’re more likely to have hearing problems as you get older. Examples include construction workers or airplane mechanics. And it is true that if you blast the music in your ears through your headphones, you are likely causing damage that will manifest years later. 

Repeat ear infections can also cause hearing problems later in life. Diabetes, high blood pressure, osteoporosis and smoking can also cause hearing problems or make them worse. It’s important to watch your overall health to maximize how well you hear.

When evaluating hearing loss and trying to decide whether it’s a normal part of aging, I ask the following questions:

• When did the hearing loss start?
• How has it changed over time? Gotten better? Gotten worse?
• How well can you understand conversation?
• Is the problem with background noise or is there hearing loss in a quiet setting?
• Is there any type of drainage from the ear?
• Are you experiencing any ear pain?

Remember, normal hearing loss due to aging starts around our 60's, worsens slowly over time, is not painful and doesn’t cause any type of oozing from the ears. 

Hearing loss can be frustrating for both the person talking and the person listening. If you or a loved one has hearing loss, consider getting a hearing aid. Hearing aids have improved tremendously in the last five years; they’re no longer those large pieces hooked on the side of the ear. They also regulate sound much better with less interference. Too often, people with hearing loss become socially isolated because they’re embarrassed that they can’t hear. In addition, we now know that hearing loss can lead to dementia. It is important to have regular hearing tests to help prevent and deter these more serious conditions.

 Want to learn more about what your aging symptoms really mean? Check out Is this Normal? The Essential Guide to Middle Age and Beyond. 

 

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How Do I Know If the Symptoms I’m Experiencing Are Normal?

October 06, 2011

• "How many times is normal to get up at night and go to the bathroom?” 
• “If I’m having trouble hearing the television, am I going to go deaf?” 
• “Is it normal to forget where you parked your car - I’m only 40!”
• “Is it ok if my mom is taking naps during the day, or should I be concerned? She did just retire.”

 

These are common questions that I get from patients as they get older. And it can be challenging to know the answers when you’re not a medical professional. Yet, it is important to be able to tell the difference between what is a normal part of aging versus a disease. Just because you’re getting older doesn’t mean you should be having ten different medical problems. Yes, you will have some problems such as trouble reading fine print by the time you’re 40, but you’re not going to start having a life of aches and pains just because you’re older. 

 

I find there are two sorts of patients – those that come in whenever they have any change in a body function, have scoured the internet and now think they have a brain tumor; and then there are those folks who rarely ever come into the office with complaints because they attribute it to “I’m just getting old.” The reality is that it is often diseases that make getting old frustrating, not the normal changes associated with aging. As we get older, too often we are embarrassed to bring up concerns to our doctors, or even get advice for our aging parents. So people needlessly live with pain, depression, bladder problems, vision problems – all the time thinking that these are normal changes, when sometimes they are not!

 

So I’m here to help you get some more information as to when you should be concerned about that mole on your back, and when you should say that’s just a normal part of aging.  Take the quiz, and let’s see how you do.

 

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Is This Normal? The Essential Guide to Middle Age and Beyond

July 20, 2011

Is it normal to forget where you parked your car? Do we really shrink as we grow older? Does everyone experience lower libido as they age?

More than 78 million American adults are nearing the age when unexpected aches and pains, weight gains, sudden illnesses and confusing mental changes begin to occur. As children, our questions about how our bodies will change are met with knowledge and patience—anything to make the transition as seamless as possible. But at 50 or 60, there’s no one to help us figure out whether the changes we’re experiencing are a cause for concern or just a normal part of aging.

Is This Normal? is a guidebook that focuses on putting this generation at ease by answering their most common questions. From superficial concerns to everyday aches and pains to more serious medical problems, Dr. John Whyte, chief medical expert at Discovery Channel, cuts through the confusion and provides practical answers for the most common age-related health issues. In Is This Normal?, he answers a broad range of questions, such as:

• How much weight gain is normal as we age—and why is it so hard to lose?
• Is it normal to need a pair of reading glasses just to decipher a restaurant menu?
• What are the signs of Alzheimer’s versus normal memory loss?

With compassion, reassurance, and friendly guidance, Dr. Whyte provides cutting-edge medical advice for the effects of aging we face every day—from gray hair and wrinkles to cardiovascular health. Is This Normal? arms readers with the essential knowledge and preventive strategies they need stay healthy and vital for decades to come. 

Buy the Book Today!

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Texting Is More Dangerous Than You May Think

June 14, 2010

As I was driving to work this morning, I noted a number of people shuffling along the sidewalks, eyes peering down at their mobile devices with their fingers tap-tapping away. While stopped at an intersection, I actually witnessed someone collide with a passerby walking in the opposite direction….kaboom!  The "typer" was so engrossed in what he was writing that he simply did not realize he was on a collision course with someone else.  Luckily, there was no serious damage, except for perhaps some scattered papers and a bruised ego.  But the result could have been more serious.  And this isn’t the worse I have seen – I’ve even seen bicyclists text and ride --- how they do it, I don’t know nor do I want to try it!

Indeed, with the rising popularity of mobile technology, this is not uncommon to see. We have grown increasingly connected to the world around us through laptops, cell phones, personal organizers, and mobile everything -- but what many of us do not realize is that being so connected can be harmful to our health.

The risks of working at a computer for too long have been well emphasized for years. Overuse of electronic devices -- commonly computers but also video games and mobile phones -- can lead to repetitive strain injuries. This is a general term that refers to the strain in the upper extremities from prolonged repetitive activities, like typing. Have your heard of the “Blackberry thumb”?  This is a relatively new term to describe the pain arising in one’s thumbs and wrists from repetitive typing on the tiny keypads.  It’s not just our arms that can become painful.  Poor posture while using these devices puts us at risk for chronic low back pain, neck pain, and even eye strain.

I’m sure you know about the dangers of driving while texting. According to NHTSA, 5870 deaths and 515,000 injuries were caused by distracted drivers in 2009; of these, texting drivers were 23. times more likely than nontexting drivers to be involved in a collision.  Everyone, especially Oprah, is rightfully raising awareness of the dangers of distracted drivers.  But you may not be aware that there are numerous other types of injuries occurring from excessive use of computers.  Did you realize that in the last few years, there have been over 70,000 emergency room visits for computer-related injuries, most commonly tripping and falling over computer equipment?  This is certainly a testament to how dangerous technology can be!

Technology certainly can improve many aspects of our life.  But like most things, it needs to be used in moderation to maximize our health. Though we may think it absolutely essential to send that email or text message immediately, sometimes it’s best to take a break and disconnect for a little while. Our thumbs will thank us.

How Big is Your Teaspoon?

February 17, 2010

All moms and dads know the drill—the sick kid, middle of the night shuffle into the bedroom with a syrup of some kind in hand. You pour it onto a spoon, send it down the hatch, feel junior’s forehead, then try to go back to sleep. Parents have performed this ritual since the beginning of time, but getting the right amount of medicine into your child is an inexact science at best.

Blame it on the spoon. Sometimes you’ll pour too little, sometimes too much, depending on its size. Like everyone else, you probably assume the dose is close enough -- that it all evens out in the end. But the practice isn’t as benign as you might think. Spoons have actually been linked to dosing errors and pediatric poisonings.  

A recent article in the Archives of Pediatric and Adolescent Medicine¹ looked at how close moms and dads came to giving their children a 5 milliliter dose of a common liquid medicine using various methods, including spoons and those little cups that come packaged with medications. After testing nearly 300 parents, researchers discovered that 50% or them made mistakes, even the ones who were confident they’d gotten it right. The spoons you take out of your kitchen drawer and the convenient cups were among the worst culprits.  

The FDA recommends against using kitchen utensils to give, or take, liquid medications. So do I. Safer alternatives are out there, and I encourage my patients to use them. The best bets are measuring droppers, dosing spoons, and oral syringes, especially the ones with bottle adapters. Any of these options will get you within safe range of the desired dose, and you can pick them up  at your local pharmacy.

Research shows that no matter how sure you are of your ability to dole out the recommended dose, getting it right is a tricky business. So the next time you have to give your child liquid medication, skip the spoon and play it safe.

[1] Arch Pediatr Adolesc  Med. 2010;164(2):181-186

Resolutions need to be from the heart, and for the heart

January 11, 2010

Oh yes, 2010 has finally arrived. The start of a new decade!  Hard to believe that many of us were worried about the "Y2K" bug just a decade ago!  Does that really seem ten years ago? Where has that time gone? Before we know it, we will be writing about 2020.

 Just as in 2000, certain traditions prevail, including the esteemed tradition known as the New Years Resolution. I bet you have made one or two...and by this point, some of us have already broken those resolutions.

My good friend, Dr. Mehmet Oz, has discussed this issue as part of the "Ultimate 20," and believes that resolutions have the best success rate when they have a personal meaning.  Specifically, he believes that people do not simply follow through on their resolutions based on what they know alone (the "factual component"); instead, they require an emotional component for the greatest success rate. So what exactly comprises the "emotional component" for successfully obtaining a New Year's resolution?

For instance, let's say you are trying to focus on removing two "vices" from your lifestyle, specifically  smoking and unhealthy diets. Already, many of us know about the need to quit smoking or follow a healthy diet. Smoking has been linked in literature with lung cancer and increased mortality. Diseases such as hypertension and diabetes can result, in part, from an unhealthy diet that is high in salt and sugar. Surely the literature proclaims a need to change your lifestyle, but one is often left pondering the question- "what is in it for me besides some academic findings from literature?" And somebody always knows somebody who smokes and seems fine.

The answer is simple- other people are depending on you and your attainment of these New Year Resolutions! When you know a spouse, dear friend, or significant other wants you to quit smoking and improve your diet, this strikes at your emotions. You certainly don't want to let them down; of course they believe in you and they will certainly be there for support! So this embodies the "emotional support." Facts are good to know, but they do not always have a personal touch!

But of course, training for this lifestyle modification will not be easy. In light of this challenge, Dr. Oz mentions that the pathway to better health is similar to a marathon. If you are aiming for a successful completion- you need to keep on a constant training regimen. You cannot start one day and then stop a few days later.  Of course, similar to an exercise program, if you have someone who is ready to "practice" with you on that "marathon" to fulfill your New Year's resolution, it makes achieving and maintaining your goals all that much easier.

So, when feeling that your New Year's resolutions are somehow unobtainable, think of Dr. Oz and his philosophy. Don't just think of only yourself, think of the benefits you will give for others!  Think of the way that achieving your goals will help both you and your special team of support! Here's to a great 2010 for all of you and to making sure that you both accomplish your New Year's resolutions and maintain them going forward!
 

Sleep—Too Much of a Good Thing?

January 08, 2010

I realize that everyone is talking this month about the need to get more sleep. With the
holiday season over and busy work days back upon us, we are flooded with messages
urging us to get sleep despite the numerous time constraints of our daily lives. And I
have even written in the past to sleep better.

It is true that too little sleep is bad for your health – it can cause a heart attack, it can
make you gain weight, as well as increase your risk for cancer and even make you die
prematurely. But what about the flip slide – is it possible to get too much sleep? And
what counts as “too much”?

A recent article in the Journal of Sleep Research looked at the association between the
number of hours we sleep and the possible health risks. After looking at the results from
over 20 other research studies, researchers discovered that adults who sleep on average
more than 9 hours per night experienced more health problems such as obesity and stroke
than those who got a restful 7-8 hours. Some scientists believe that too much sleep is
actually more dangerous to our health than too little sleep.

Now I’m not talking about those of us try to “catch up” on sleep on the weekends, trying
to make up for the nights we sleep too little. (And I might point out there’s no such thing
as “catching up on sleep.”!) The exact mechanism for the increased health problems is
not known but some think longer sleep leads to less exposure to daylight, as well as lower
levels of beneficial stress. That’s right…some stress can be beneficial.

 I often find that when patients come in complaining of too much sleep that there is often
an underlying problem. Often, they are depressed and don’t have an interest in getting
out of bed. Depression is often under-diagnosed and too much sleep can be an early sign.
Luckily there are good therapies – both with and without drugs to fight depression.
Others actually are equating the number of hours in bed with sleep, when in fact they are
getting too little sleep due to restlessness and sometimes chronic pain. And if you are
sleeping during the day, that could be a sign of obstructive sleep apnea.

I also want to point out that as we get older, we do not need more sleep. I can’t tell you
how many patients come in with elderly parents and complain they sleep all day. Well,
something is wrong there and should be evaluated. As we get older, the quality of our
sleep decreases but the total amount of sleep should stay the same --- 7-8 hours.

Like many of you, I do like to sleep! One of the reasons I did not go into surgery or
anesthesiology is that I don’t like to get up before 6 am! I do recognize, however, that
developing a good sleep regimen is important for good health. So like many others have
told you, establish a regular sleep time in the evening and wake-up time in the morning
and stick with it every day, including weekends. Sleeping longer on weekends actually
messes up our biologic clocks. It’s only natural that there are going to be days when you

sometimes get more, and sometimes get less. But aim for 7-8 hours of sleep a night, and
you will do well! Like a lot of things, too much sleep isn’t good for you!

What’s in Your iPod?

June 05, 2009

I usually use this space to talk about different therapeutic options like drugs and medical devices for diseases and other conditions.  Like most people, I sometimes overlook simple things.  For instance, did you know that listening to music can improve health?

A recent study showed that listening to music dilated people’s blood vessels by nearly 25%. Participants listened to 30 minutes of their favorite music daily.  At the end of the study, they actually had lower cholesterol levels as well as improved heart function.  It’s unclear exactly how music caused these improvements but it may be because the music-induced dilated vessels increases blood flow to the heart. Listening to music may also cause the release of nitric oxide which might help prevent buildup of clots and cause reduction in cholesterol formation.

Another study showed that stroke patients who listened to music daily actually had improvement in their vision, and actually had shorter recovery times.  There’s even some data to show music might improve memory.

Granted, these studies are preliminary and more research needs to be done but it’s hard to argue that listening to your favorite music is a good thing to do.  Who hasn’t found some reduction in anxiety by popping in their favorite CD into their stereo?  Who hasn’t had certain songs bring back special memories from childhood or momentous occasions that allowed you to escape for a few minutes?  Listening to music you enjoy can have real value in improving your health.  But remember – make sure it’s music you like!  Listening to Meatloaf if you’re a classical music aficionado will not be a good thing to do!

So what’s in your iPod?  I have quite a mix of songs in mine…I listen to rock and pop during gym sessions to get the heart pumping and give me the added energy to run further or lift heavier.  If you don’t think music makes a difference, see how your exercise varies if you listen to slow music or none at all! Sixty minutes will seem like 2 hours.

My iPod has become invaluable in keeping stress levels down while I’m navigating through airports and train stations.  Listen to a little Coldplay or The Fray, and those long lines don’t seem so troublesome.  And turning up Bach or Puccini while in traffic jam is a convenient way to tune out the blasting horns from other cars.

So remember the simple things when it comes to your health - take some time today to listen to 30 minutes of your favorite music.  Your heart and brain will thank you.