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Blog Archive

A Quick Guide to Braces Apr 24th, 2024

Braces come in all shapes, sizes, and forms including trochanteric belts, corsets, molded jackets, sacroiliac belts, and more. A brace is meant to hold a specific part of your body relatively in place to alleviate pain and assist with healing. For those that suffer from chronic pain, braces can be...

Best Exercise Equipment for Back Pain Apr 18th, 2024

When experiencing back pain, it’s not unusual that the last thing one would want to get into is a workout routine. Traditional exercises like stomach workouts, weight lifting, push-ups and sit-ups are not recommended for those with chronic back pain, as these exercises tend to put unnecessary stress on your...

Bad Posture Habits to be Aware Of Apr 10th, 2024

You may have been told by a concerned friend or family member to stand up straight in order for you to recognize your poor posture. Kyphosis, or the rounding of the upper back, is a common sign of bad posture. Recent studies have shown that having poor posture can negatively...

Is Back Pain a Sign of Something More Serious? Mar 18th, 2024

If you’re reading this, you may be experiencing painful and consistent back pain that’s strong enough to be causing you to be worrisome and anxious. While a qualified pain professional can give you a proper diagnosis for the root cause of your back pain, there are different signs you can...

Telehealth: The Advantages of Telemedicine Feb 20th, 2024

The COVID-19 pandemic has triggered dramatic changes throughout everyday life — and in the medical community as well. Not only are providers across the country postponing elective procedures, but many are also encouraging people to avoid in-office appointments to reduce their risk of exposure to this highly contagious coronavirus.But what...

How Do High Heels Affect Long-Term Spine Health? Jul 5th, 2023

Although stylish, high heels are infamous for their discomfort and negative effects they can have on spinal health. When women wear high heels, they do so to look fashionable, without really considering the harsh health effects they can have. In fact, some studies have even shown that wearing high heels...

What You Should Know About Complex Regional Pain Syndrome Jul 5th, 2023

Complex regional pain syndrome is a fairly uncommon type of chronic pain typically affecting both the upper and lower extremities. The condition, however, is common among patients post-surgery, stroke, or heart attack. The pain experienced by those affected is not in proportion to the severity of the injury - the...

Happy Independence Day! Jul 2nd, 2023

Our Dearest Patient,  We hope this email finds you in good health and high spirits. As we gear up to celebrate Independence Day, we wanted to take a moment to extend our warmest wishes to you and your loved ones. Independence Day is a time when we come together as...

4 Common Arthritis Misconceptions Jun 21st, 2023

Arthritis occurs when joints responsible for motor skill such as the fingers, wrists, and knees become inflamed. As we get older, arthritis can worsen with age and eventually lead to severe joint pain. In the United States, arthritis affects roughly 40 million Americans throughout the country. There are two types...

What You Should Know About Sciatica Pain Jun 21st, 2023

Contrary to popular belief, the term “sciatica” refers to a symptom rather than a diagnosis. Sciatica describes the numerous types of lower leg pain including chronic leg pain, leg tingling and weakness, and more. Typically, sciatica pain originates in the bottom portion of your lower back and radiates towards the...

Pain Management While Traveling May 25th, 2023

Going on vacation can cause an array of mixed feelings when dealing with arthritis, fibromyalgia, or other forms of chronic pain. You may be happy to get away for a little bit, but the thought of being in pain on vacation may be discouraging. Rest assured, however, with preparation and...

5 Most Common Motorcycle Injuries May 25th, 2023

Motorcycle riding is a beloved pastime by many motor enthusiasts in the United States. In New Hampshire, there are almost 150,000 motorcycles registered in the state. Motorcyclists are far outnumbered by the over 3 million registered cars on the road. Taking this into consideration, riding a motorcycle is one of...

The Do’s & Don’ts of Dealing With Knee Pain Apr 5th, 2023

There are a variety of options to deal with knee pain or a stiff knee. However, most people unintentionally make their knee pain worse while attempting to cope with it. For example, when we experience pain, our first thought is to rest and when we are experiencing knee pain, we...

Outdoor Activities for Relieving Stress & Pain Apr 5th, 2023

Exercise involves any type of physical activity that relieves stress. Both stretching and exercising can aid in reducing certain types of pain including back pain. Some of the top outdoor activities that the experts at Pain Specialty Group recommend to help lower your stress and relieve your chronic pain include...

Can Relaxation Relieve Pain? Feb 24th, 2023

Approximately 100 million Americans suffer from chronic pain on the daily. Chronic pain is difficult for physicians to diagnose, as this condition is used to describe persistent pain that lasts longer than six months. Pain signals remain active in the nervous system for extended periods of time, from just a...

Gardening and Its Many Health Benefits Feb 23rd, 2023

Hobbies have a therapeutic effect on people, especially those that suffer from chronic pain. With springtime quickly approaching, participating in outdoor hobbies and enjoying the sunshine is sure to help with your chronic pain. Gardening has both psychological and physical benefits. This beloved hobby can be enjoyed by individuals of...

Neck Arthritis: What You Should Know Feb 23rd, 2023

Aging can be a pain in the neck, literally. Almost everybody experiences some degree of cervical vertebrae degeneration as we age. Most doctors believe vertebrate degeneration results from our relatively small neck bones, carrying a 9 to 10 pound head, that wear out overtime. Those with severe degeneration are susceptible...

The Impact of Pain on Dieting Feb 23rd, 2023

Pain and dieting are two topics that are often discussed separately, but they are actually interconnected - Pain can affect dieting and vice versa. Pain is a common experience for many people, and it can be caused by a variety of factors such as injury, illness, or chronic conditions. Dieting,...

Pain & Overeating Feb 23rd, 2023

Let's be honest, who hasn't reached for that second (or third) slice of pizza in an effort to distract yourself from your aches and pains. We've all been there. But here's the thing: overeating isn't a cure for pain. In fact, it can actually make things worse! Overeating can lead...

What Are Trigger Points? Feb 3rd, 2023

Myofascial trigger points, or commonly known simply as trigger points, are areas of your body hypersensitive to pain. The term myofascial refers to muscle tissues (myo) and the connective tissues (fascia) in and around them. Myofascial trigger points are unique in how they affect different areas, but similar to normal...

The Link Between Pain & Depression Jan 27th, 2023

Unfortunately, chronic pain can lead to depression. But, it’s important to understand the link between the two of them, in order to solve it. There are a wide variety of solutions if you’re feeling down and depressed from your experienced chronic pain. For example, some patients may benefit from getting...

Ways to Deal with Chronic Pain (Other than Medication) Jan 18th, 2023

Those that suffer from chronic pain may find taking pain medications beneficial in treating their pain. However, it’s important not to solely resort to medications - there are alternative therapies that can help reduce your pain. In fact, these therapies can even help in decreasing your medication dosage. Activities like...

Signs of a Concussion After a Car Accident Jan 17th, 2023

The Center for Disease states that about 2 million Americans experience concussions every year. A concussion is a mildly traumatic brain injury. These are commonly “closed head” injuries, therefore there isn’t a penetration to the skull and the injury was caused by a forceful impact to the head. 14.3% of...

Can Pets Help You Cope With Chronic Pain? Jan 13th, 2023

Owning furry friends can actually be beneficial to your health. Studies have discovered a distinct connection between a reduction in patient-reported chronic pain and pet ownership. Additionally, owning a pet can aid in reducing the likelihood that chronic pain will lead to depression. Research shows that depression is more likely...

Exercises for Back Pain Jan 12th, 2023

Exercise is a great way to alleviate pain, when done properly. There are many exercises out there that require prior knowledge on how to perform it. This includes proper form, repetition, and resting periods. These are vital in order to not cause or increase back pain. Some specific exercises that...

Signs and Symptoms of Chronic Pain Jan 11th, 2023

With the impact that chronic pain can have on your daily life, many enjoyable moments can be ruined. There are about 25.3 million Americans suffering from chronic pain, however diagnosing your chronic pain can be a difficult task. Even though chronic pain must be diagnosed by an experienced doctor, if...

3 Tips for Avoiding Slip & Falls in Winter Jan 10th, 2023

With New Hampshire entering the middle of winter, we need to be more careful than ever to avoid the chance of a slip and fall accident. Snow and ice can mix to transform sidewalks and streets into slippery safety hazards. Slip and falls, although avoidable, are one of the most...

5 Tips for Reducing Pain While Skiing Jan 6th, 2023

Skiing can be one of the most exhilarating ways to enjoy the cold winter months. The feeling of surging down the slopes can give you an adrenaline rush like no other. But, the ensuing bodily pain afterwards can be brutal for days on end. Unfortunately, back pain is one of...

Top Features to Look for in a Chair to Improve Posture Jan 6th, 2023

The connection between pain and poor posture becomes more evident as more studies are done regarding chronic pain. The environment in which you work can worsen back pain, especially those with office jobs. It's proven that sitting for extended periods of time causes forward hunching and slouching, which over a...

How Ginger Can Work to Fight Pain Aug 12th, 2022

Medicine works hand-in-hand with Mother Nature to derive the modern-day treatments that we rely on for a good quality of life. There are foods and plants out there that are actually still relied on for their therapeutic benefits. For example, salmon, olive oil, leafy greens, and ginger all have both...

How Your Sleeping Position is Affecting Your Back Pain Aug 12th, 2022

The National Sleep Foundation recommends the average adult should get an average of 8 hours of sleep each night, which means about a third of our days should be dedicated to sleeping. However, laying in a horizontal position for this amount of time can actually affect the curvature of your...

Symptoms to Watch Out for After a Car Accident Aug 4th, 2022

When in a car accident it can be difficult to determine whether you were injured or not, due to the adrenaline most people are experiencing in that moment. Injuries left untreated from a car accident can lead to back pain with an increase in pain over several days, weeks, or...

Chronic Pain & Massage Therapy? Aug 3rd, 2022

There are many options to treat and address chronic pain besides surgical procedures. Although there are a vast number of options to choose from, recent research points to massage therapy as a viable alternative and non-invasive treatment for chronic pain. A massage therapist may alleviate pain to the same extent...

Taking Pain Medications Safely Aug 3rd, 2022

Pharmacies offer hundreds of  over-the-counter medications and painkillers that are easily accessible for you. The countless brands and options of medications available, bring a slew of directions and warnings about how the medication should be properly taken. It’s very easy for misinformation to spread fast, leading to an increase in...

Mobile Apps That Can Help Manage Pain Aug 3rd, 2022

Chronic pain can be a burden to those that it affects. With the intensity and persistence that chronic pain brings, can make it difficult for people to focus on everyday life, hobbies, and work life. And, feeling the need to manage your chronic pain can be just an added, unnecessary...

Top 3 Exercises for Fixing Your Posture Aug 3rd, 2022

As many know, poor posture can affect your health, mood, and overall comfort. Therefore many know they need to improve their posture as a way to realign their back, but don’t know where to start. While there is no direct way to instantly improve your posture, there are certain changes...

Pain Research to Keep an Eye On Aug 3rd, 2022

Even with all the research breakthroughs to date, there are still many more to go. Research is still trying to answer many questions relating to pain. Some of these include, how can it be treated, when does it start and why does it start. This is why it is important...

Using a Tennis Ball to Relieve Pain Aug 3rd, 2022

Simple, everyday items can be beneficial in helping you alleviate your pain and discomfort. Prior to pain treatment, people needed to come up with creative ways to minimize their pain. One particular method involves using a tennis ball to massage muscle knots caused by pain. Tennis balls work to relax...

How Inflammation Causes Pain Aug 3rd, 2022

In your body, there are several systems that help repair and prevent injuries. One such system, inflammation, works to protect your body by eliminating harmful agents like pathogens, damaged cells, and other irritants. Symptoms of inflammation include joint pain, redness, and sensitivity. When this happens, your body is trying to...

How to Extend Hikes with Chronic Pain Aug 3rd, 2022

Hiking is a relaxing activity that allows you to experience  wonderful views, and gives you an escape from  technology and other worldly distractions. Going on a hike can be peaceful, which may be hard to find in your daily life when dealing with chronic pain. But, chronic pain does not...

What is Osteopathic Manipulation? Aug 3rd, 2022

Basic methods of treatment can sometimes be overlooked with new technological and medical advances. For many patients, being placed on another medication is undesired as they would rather feel the “healing touch of a doctor.” If you can relate, an alternative treatment known as Osteopathic Manipulation may be in your...

The Pain Cycle Aug 3rd, 2022

The cause of chronic pain can stem from an injury that results in your body having trouble moving naturally. This imbalance in motion can cause poor posture which is a leading cause of the pain cycle. By looking at this cycle, experts are able to see how your body compensates...

Four Essential Items For People Who Suffer from Chronic Back Pain Aug 3rd, 2022

Back pain, especially low back pain, affects millions of individuals worldwide. Simple everyday activities become difficult to perform for people with back pain. As discouraging and uncomfortable experiencing back pain is, it is important to not allow back pain to control your life or conquer your positive spirit. Applying ice...

How a New App is Helping Doctors Treat Pain Aug 3rd, 2022

As a patient, it can often be very frustrating describing your pain to a doctor especially as a chronic pain patient. Difficulties can stem from not knowing how to accurately describe the severity of pain being experienced. Fortunately, a new phone app and website called Pain.com aims to relieve some...

Happy Independence Day from Pain Specialty Group Jun 23rd, 2022

Happy 4th of July from Pain Specialty Group Our Dearest Patient, As the warm weather approaches, we wanted to reach out and wish you a safe, happy, and healthy summer. With this warm weather comes many opportunities to get out and get active. However, it is important to keep any...

How to Parent with Chronic Back Pain Jun 23rd, 2022

Even though living with chronic pain is a challenge for everyone, it is exceptionally hard for those with children. As if managing your pain was not enough, you also have to keep up with kids who may not necessarily understand your limitations. Whether you’re the proud parent of a newborn...

How Employers can Accommodate Employees with Chronic Pain Jun 21st, 2022

As an employer, your employee’s comfort can have a big impact on the quality of his or her work. It is proven that happier employees are more likely to work for you longer, communicate openly, and volunteer to help their coworkers. Working with an employee who suffers from chronic pain...

Three Things a Chronic Pain Patient Wants You to Understand Jun 21st, 2022

Chronic pain is a condition like no other. When you break your leg, it is obvious that your leg is broken. Or, if you were severely burned, the pain that it caused is obvious. Chronic pain, however, is unique in that it is completely unidentifiable. You would probably never be...

Traveling with Chronic Pain Jun 21st, 2022

How to Address Chronic Pain While on Vacation When it comes to traveling, patients with chronic pain seem to have the most trouble with it. Even though getting a breath of fresh air and light exercise can be great for the body in both a physical and mental capacity, traveling...

Possible Links Between the Brain and Chronic Pain Jun 21st, 2022

It can be very difficult, and a major source of frustration, as a chronic pain patient to be told that you are imagining your pain or that it is “in your head”. This statement also allows for the belief that anything happening in the head is only minor even though...

Pilates for Chronic Back Pain Relief Jun 21st, 2022

Many healthcare professionals recommend Pilates to all people. However, patients who suffer from chronic back pain may find Pilates useful, as it is known to help improve flexibility and strength. Pilates is not only a great option for pain relief, but this activity teaches individuals how to avoid movements that...

Monash Pain Treatment May Break New Grounds Jun 21st, 2022

With the daily improvement of technological and medical advances, there is an increasing number of impressive developments in many areas now more than ever. Diseases, illnesses, and ailments that were once thought to be untreatable are now becoming more manageable. Recently, the top one hundred universities in the world located...

Can Meditation Relieve Chronic Pain? Jun 21st, 2022

It can be hard to hear as a patient that chronic pain is something you are going to have to live with regardless of treatment. However one option of treatment that is often overlooked is meditation. Meditation has been shown to be a viable pain option. It requires focusing your...

Canes for Chronic Back Pain Jun 21st, 2022

Canes are tools used to assist people who experience balance issues. Although canes are most commonly used by the elderly, canes can be useful to all individuals who suffer from chronic back pain and aid in their  ability to stand upright without support. Typically, people are afraid that using canes...

Chronic Pain in Children Jun 21st, 2022

Why Would a Child Have Chronic Pain? Many people have the misconception that chronic pain only affects adults, however it has the ability to affect everyone, including children. Over the years, chronic pain is an increasing issue becoming more common in children and young adults. These issues can come from...

What is Workers’ Compensation? Jun 21st, 2022

What is it? Workers’ compensation is a form of insurance that provides medical assistance for injuries and illnesses caused while working. New Hampshire employers provide workers’ compensation insurance. Once the claim is filed and is approved, the workers’ compensation assists with all essential medical services. How can Pain Specialty Group...

Is it Time to Get a Spinal Cord Stimulator? Jun 21st, 2022

The journey to pain relief can be very frustrating and often can feel like an impossible and never-ending journey. At Pain Specialty Group, our providers are aware that conservative methods of pain treatment may not always be sufficient to help a patient’s condition. Additionally, a patient may not be a...

Why Women are More at Risk for Arthritis Jun 21st, 2022

Arthritis in Women Arthritis is a common joint condition where one or more joints become stiff from inflammation which leads to pain that increases as one gets older. While more men find themselves with arthritis before the age of 55, the amount of women dealing with arthritis rises dramatically after...

How Good Nutrition Can Help With Chronic Pain Jun 21st, 2022

When dealing with chronic pain, much of the advice emphasizes maintaining proper posture, stretching and exercise. While the majority of chronic pain symptoms do come from mechanical issues with the spine or nerves, good nutrition can help prevent and alleviate your chronic pain as well. The benefits of a healthy...

How a Muscle Knot Can Cause Pain Jun 21st, 2022

Muscle knots are hard, sensitive areas of muscles that tighten and contract, even when the muscle is at rest. These tense muscle fibers can cause pain in other parts of the body when touched. If left untreated, a muscle knot can cause increased pain over time. This can lead to...

Treatment of Long (Post) COVID-19 Symptoms Jun 21st, 2022

What is Long COVID? The COVID-19 pandemic is an ongoing health crisis that has taken and affected lives worldwide. For some, contracting COVID-19 results in mild cold-like symptoms lasting a few days to a week, but for an ever-increasing number of people, the physical effects of COVID-19 can extend to...

Three Benefits of a Pain Support Group Jun 21st, 2022

Chronic pain is a difficult issue for many. You wake up every day feeling less capable of doing what you need and want to do because of your body’s physical limitations. You may feel that the only person who can begin to understand your troubles is your doctor, as friends...

Three Methods for Coping with Chronic Sciatica Dec 25th, 2021

When you're limited or disabled by chronic sciatica, it's easy to lose hope from the severity of pain. At Pain Specialty Group, our board-certified and expert pain management specialists understand how debilitating chronic sciatica can be. Learn more about chronic sciatica and three different methods for finding relief from chronic...

Happy Holidays 2021 from Pain Specialty Group Dec 25th, 2021

Happy Holidays 2021 from Pain Specialty Group Our Dearest Patient,As the holiday season is officially underway, we wanted to reach out and wish you well. We hope this holiday season is the best one you have yet. Here at Pain Specialty Group, we have a lot to be thankful for...

Is Chronic Pain and the Brain Connected? Dec 25th, 2021

Is It All In the Head? Society has many unfair stigmas and misconceptions, especially when it comes to chronic pain. One of the most common misconceptions as it relates to chronic pain is that a patient's pain is "just in their head". This is frustrating to many people as it...

Cancellation and No Show Policy for Office Visits, Procedures & Surgery Sep 6th, 2020

At Pain Specialty Group, our goal is to provide quality treatment and care in a timely manner to all our patients.  We schedule our appointments so that each patient receives the right amount of time to be seen by our providers and staff.  We have implemented a cancellation and "no...

COVID-19 and Your Safety May 9th, 2020

Coronavirus COVID-19 Patient Safety fromPain Specialty Group Dear friends of Pain Specialty Group:We hope that this letter finds you and your family in good health. We have all been through a lot over the last few months, and cannot wait to see you again!!We are reaching out to ask you...

Digital Visit - Telemedicine Pain Clinic Mar 20th, 2020

  Our Dearest Patients,The health and well-being of our patients is our top priority, now and always. In response to the coronavirus pandemic and the guidance provided by the U.S. Centers for Disease Control, we have decided to institute measures to help keep patients safe while continuing to provide excellent...

Pain Specialty Group - Communication on COVID-19 Mar 14th, 2020

Our Dearest Patient,In light of concerns related to the spread of coronavirus, also known as COVID-19, we want to reassure you that now, more than ever, our commitment to your health and safety is our top priority.WE ARE EXERCISING EVERY POSSIBLE PRECAUTION TO LIMIT RISK:• Employees who are sick or...

Low Back Pain, Vertiflex's Superion and How Can It Help Mar 14th, 2020

  Low Back With Leg Pain With an increasing number of patients diagnosed with chronic low back pain in the United States, our specialists at Pain Specialty Group strive to integrate innovative and leading edge treatments for patients in New Hampshire’s Seacoast and Maine.  Either you or somebody you know...

Treatment Options for Arthritis Mar 2nd, 2020

When you’re limited by or disabled by arthritis, it’s easy to lose hope in treatment.  At Pain Specialty Group, board-certified pain management specialists Manuel G. Sanchez, MD, and Anh L. Ngo, MD, MBA, understand how debilitating arthritis can be, especially in its advanced stages. Learn more about the different types...

Can Pilates Help Treat Low Back Pain? Mar 1st, 2020

Low back pain is a common condition that often is a struggle for physicians and patients to treat.  Management plans widely vary and frequently depend on a patient's age, height, weight and other health factors.  Compared to the other treatments available for low back pain, Pilates is considered a conservative...

Pain in the Breast: A Comprehensive Review of Chronic Pain Following Cosmetic Breast Surgery Mar 1st, 2020

As one of the co-authors, Dr. Anh Ngo in collaboration with our research group from leading U.S. academic institutions recently compiled and published in Pain and Therapy Journal a comprehensive review of chronic pain following cosmetic breast surgery.  The research team provided the review as an update on the current...

Your Hand Hurts? A Comprehensive Review of Injection Techniques for Common Chronic Pain of the Hand Feb 29th, 2020

As one of the co-authors, Dr. Anh Ngo and our research group out of leading U.S. academic institutions recently compiled and published in Pain and Therapy journal a comprehensive review of literature on common chronic pain conditions of the hand. In the article, we presented common conditions with their biological background, diagnosis,...

Everything You Need to Know About mild® for Spinal Stenosis Feb 1st, 2020

When you’re suffering from chronic back pain or limited in your mobility due to spinal stenosis, you may be a candidate for treatment with mild®, a safe, minimally invasive procedure available at Pain Specialty Group. Our interventional pain management specialists offer comprehensive care for spinal stenosis, using the mild system to improve...

Top 5 Ways to Tell if Spinal Cord Stimulation is Right For You Jan 2nd, 2020

Pain is actually a good thing. It alerts your body when you’re injured and lets you know you need to protect that area from further harm.  But what happens when the injury is gone but the pain persists? That’s called chronic pain and it plagues more than 20% of Americans....

Our 2020 New Year's Resolution from Pain Specialty Group Jan 1st, 2020

Happy New Year from Pain Specialty Group We’ve made a New Year’s Resolution for 2020 and the new decade:To bring you the most innovative and impactful solutions to help restore and maintain your health and happiness.As you know, we are with you in your journey for pain relief and truly...

Top 5 Reasons Why Digital Triage is Better Than Leaving a Voicemail Dec 29th, 2019

Top 5 Reasons Why Digital Triage is Better Than Leaving a Voicemail Have you ever called the clinic at Pain Specialty Group only to end up with a voicemail?  Have you called again only to obtain the same recorded message on the other end?  Frustrated and wondering, have you called...

Get Patients Seen with Express Referrals for Clinicians Dec 25th, 2019

Express Referrals for Referring Clinicians It's simple as 1, 2, 3. Referrals made easy. On behalf of the team at Pain Specialty Group, we present to our doctors and clinicians an easy and quick way to refer patients.  Introducing Express Referrals by Pain Specialty Group, our digital solution for expedient and...

A Special Holiday Wish from Pain Specialty Group Dec 23rd, 2019

A Special Holiday Wish from Pain Specialty Group On behalf of the team at Pain Specialty Group, we wish you and your family a very special holiday and Happy New Year!We understand that pain relief is a journey and we truly strive for your return to health and happiness. We...

What You Should Consider When Looking for the Ideal Pain Practice and Pain Providers Dec 8th, 2019

If you’re in pain, you’re not alone. As many as 40% of Americans experience chronic pain, according to the Centers for Disease Control and Prevention. As you might imagine, people who are in pain have a lower quality of life than those without pain, and they’re more likely to suffer...

How Ketamine Infusion Therapy Works to Help Chronic Pain and Depression Nov 18th, 2019

Chronic pain and depression are health conditions that often go hand in hand. Many people who suffer from long-term pain and health problems, like neuropathy and spinal pain, also suffer from depression. After all, when you wake up each day faced with debilitating pain, it’s understandable that you become less...