Health · Medical · Multiple Sclerosis · PAIN · Ramblings · RANDOM · Sadness · Strength

DeNiEd AgAiN

Some of the not so great things that happened to me in the past six months or so is that I was denied acute physical therapy rehab. I went through every one of their appeals and was denied every time. They say for me it’s not medically necessary and basically that’s the only reason given. Let me think, I have severe hip contractures due to being bedridden, yet acute physical therapy isn’t medically necessary for me. 🤔 The story goes a little something like this…

On August 18, 2019 my husband was trying to get me into the sling for my Hoyer lift so I could get out of bed. As he started lifting me and the sling pulled up around my body, the pain was so excruciating I really believed my hips were going to break. Needless to say I never made it all the way up or out of my bed. We called 911 and I was taken to Palmdale regional medical Center. At that time we weren’t really sure what my hip pain was. We knew that my knees and ankles had contracture issues, but my pain management doctor was saying it might be arthritis, osteoporosis etc.. The ER doctor explained that my hips had contractures just like the rest of my legs. It was as if a💡went off in my head. Like, no shit… oh my god how could my other doctor(s) not figure this the fuck out. The rehab institute at Palmdale regional medical Center was where I had been for one month in February 2018, so I asked if they could contact my doctors and try to get me back in. It took the next two nights and three days before Independence Blue Cross came back with, DENIED. After exhausting all four of my appeals, (4months) I was DENIED Rehab. Not medically necessary. I completely understand that the doctors that work at these insurance companies are basically rent-a-docs that probably can’t get a job at a legitimate place, but come on, I’m the poster child for rehab.  In fact, for how severe my contractures are, the only options are surgery or acute physical therapy. So that in a nutshell is my denial for, realistically, life-saving therapy for me…Now on to my new dilemma where I’m being denied. They are now saying that they will not pay for my ER visit because it was not an emergency. 🤬 When a representative from Independence Blue Cross called me to ask about this appeal for this charge, I told her what the emergency was. I explained the same thing that is stated above; how I was trying to get out of bed with the use of my Hoyer lift and the pain was so excruciating from the muscle contracture’s that I could not do it. I could not move!! Now in my book that’s a fucking emergency. obviously it was an emergency enough that they paid for the ambulance. I mean really for fucks sake.

(Attached) is what the incompetent person, I’m trying to be nice about this, said in the DENIAL letter. “You stated that you were experiencing difficulty and could not stand so you went to the emergency room for services” is she fucking kidding me?!! First off I would never have said that because I haven’t been able to stand for 6 years 2 months!!! For fucks sake I’ve barely been able to get out of my bed. I’m not sure what part of, I’m bedridden and I was having pain in my hips trying to be lifted in my Hoyer lift, that she didn’t understand. So she either lied on that form or she just didn’t give a shit to listen to what I had to say.I bet it’s a little bit of both… Lied so that the insurance company wouldn’t have to pay which falls right in line with doesn’t really give a shit. I have a call in to her, so we will see if she calls back. They are on EST and right now it’s 4:56 PM PST, so I bet she’s just not gonna call back. I really believe that these people and these money corporations do this often so people like me are not given the care that is needed. They think they can be our doctors and that they know better than our doctors.🖕

So now I get to deal with all of this. Sorry the little attachment above is a little wrinkled. When I read that line for the first time, I lost it. Everything and anything in my reach was thrown. When I realized I was trying to pull my hair out and the scratching on my face started hurting I just broke down into a big heap of tears.

At this point my body has deteriorated more and more and my muscle contractures have gotten worse and worse. I have so many calls in to so many people and they either don’t call back, or they’re rude. If anyone reads this and you know of anyone that could help me, attorney, disability advocate, hell a juggler, 😜 please send them my way. I really don’t know how much longer I can go on. Have courage and be kind.



Anger · Craziness · Health · Multiple Sclerosis · PAIN · Primary Progressive MS · Ramblings · Sarcasm · Strength · Stupid Stuff

Trapped Inside

This GIF popped up on Facebook and when I saw it I felt empty. I decided to post it because it really does sum up my life. I have been trapped inside my decaying body for approximately 6 years 2 months. It is actually a bit more but I removed doctors visits, visits to the store before my surgery in June 2014, and the occasional visits to my dads. In that time it equals to approximately 28-30 days that I’ve been out of my bed. I don’t know how it happened. What I mean by that is, I don’t know how it got so bad. October 10, 2013 I fell. I was transferring to go to the bathroom, and as I stood up my legs went limp like cooked noodles. They did no x-rays at the hospital that I can remember, they just really chalked it up to MS. The hospital and my doctors knew that I was unable to stand sit up, pretty much paralyzed from the waist down, etc. They did the Solu-Medrol bullshit which did nothing for me. Then they basically sent me home with no real after care.

This is where I don’t know how it all happened. The fall definitely started it, and then I go blank. The depression I remember was paralyzing just like my body. Then in a weird whirlwind of doctors appointments the next thing I knew I was scheduled for colostomy and urostomy surgeries for June 10, 2014. Was this medically necessary or was it done to make it easier for everyone around me? I don’t really know anymore.

Why wasn’t I offered acute rehab? Why wasn’t I offered in-home nursing care? I don’t know! 🤷🏻‍♀️ I do know that a friend, an RN, had to come to my house to catheterize me so I didn’t piss my bed every five minutes. Not sure why my doctors or the hospital didn’t do that for me. I also know, looking back, that I was completely fucking lost. I have never been someone to lie down and be stomped on, but I guess I could not find my strength back then. The surgery, for me, what horrific.  and the next couple of years were literally lived as if I were in a dream.I will fast forward to now, because I don’t have the energy to really talk about it much more. All I know is I am trapped in a body that is destroying itself from the inside out. Since I was denied rehab August 18, 2019 my body is deteriorating more and more. i’ve exhausted, in their mind, all appeals. DENIED!! 🤬  Because of this, my legs are becoming more contracted. Independence Blue Cross basically feels it’s not medically necessary for me, acute rehab! Because their doctors I guess are my doctors now and they know better. Are they fucking kidding me! I’m the fucking poster child for acute rehab! Here is a link of what is happening to me and what I sent to the insurance company thinking they would actually understand it and help me. Bahahaha They either cannot read or they just don’t care. I’m going with the latter. People are telling me I should contact news agencies, attorneys, etc., but the places I’ve contacted obviously don’t think that any of this is wrong. Either that or they’re just scared to death to take on Independence Blue Cross. I guess in the world we’re in right now it’s OK for companies like this to throw away the disabled, people with chronic illness, because we are the people no one really gives a shit about. And quite frankly, I’m tired!!! I have no help whatsoever! Mentally, physically… Nothing. 

I am 100% in prison for crimes that I have never committed. The prison that is my body and the four walls of my bedroom. There is only one or two people that completely understand what I’m going through that I know. And when other people say, they know what I’m going through, they completely understand, yet that person/persons are shown standing up in pictures and going places with family… no, you have no fucking clue what I’m going through. And you should be really fucking glad you don’t. If I were able to even stand up I would never be in this fucking bed. So please don’t talk of things of which you know nothing about. You may share my illness but you don’t share what’s happening to me.

What I hate the most about all of this is the person I’m slowly becoming. I really do believe I’m going to little mad, I can no longer see the light at the end of that tunnel, and I’m not sure why I even bother anymore. Yes it’s a new year blah blah blah… but for me there will be no changes. AND I am NOT being pessimistic, I’m being realistic!  I will add that you don’t need to worry people, I’m not gonna kill myself, off myself, end it, whatever. Do I think about doing that every fucking day… Yes I fucking do! But, I won’t and believe me it’s not for the reasons that you are probably thinking. And now, I think I’m done for the day and I think I’m going to medicate so that I don’t care what’s happening to me. And for those of you that act like I’m a stoner or something, fucking A right I am! Cannabis isn’t going to kill my kidneys or my liver like Norco and Xanax and all the other drugs they want to put me on. So yeah I love my weed. And to anyone that says that’s bad for you or it’s addicting or it’s a gateway drug, educate your stupid ass! Or better yet go pour yourself another drink or take one of your sleeping pills and then talk to me. OK I’m getting off base and I’m starting to get pissed so I’m going to end this for today.

So are you loving my new unapologetically me yet?

As always, have courage and be kind!

Craziness · FUCK · Health · Multiple Sclerosis · Primary Progressive MS · Ramblings · Sarcasm · Stupid Stuff

The word FuCk…

I made this last night and posted on Facebook because that was the type of day/night I was having. Sometimes I will literally put my pillow over my face and scream at the top of my lungs. It really does help. 🤷🏻‍♀️

The word fuck has so many different meanings. It can be used for pleasure, anger, sarcasm, jokes. I will admit, it’s my favorite word. I’ve heard that people who are sarcastic and/or use profanity are more intelligent than those that don’t. I mean hey, I fully believe that. 😜 No, I really do believe it.

I’m pretty sure I did a blog about this sometime ago, but I’m too damn lazy to check. And I don’t care. LOL I feel if I wanna do the same blog post every fucking day, I can. 😂

I’ve been told to act my age, grow up, etc.… Fuck that. I’m 55, soon to be 56 in March, I can do what I fucking want. I tell people that I’m level 55 or 30 with 25 years experience. I mean, I’ve never been this age before, so I’m not really sure who I need to look to for age experience. My body feels like it’s 1 million years old, my mind is that of a teenager. I never want to lose that part of me. That’s the part of me that gets me through the nights that I don’t want to get through. 

I’m learning that I can no longer care what people think of me. I’ve done that my whole life and I haven’t been happy. I’ve been judged by so many people and when I look at the people who are doing it, glass houses… I’m done conforming to what people want me to be. Like I’ve said, I’m going to be unapologetically me. Those that do not like the new me, can fuck off. My real family my real friends will embrace this me. The other people don’t matter. I am still a work in progress regarding this. But I’ll get there.To anyone reading this, be unapologetically you as well. You’re the only one that lives your life! ♥️

Have courage and be kind! 

FUCK · Health · HELL · Hope · Primary Progressive MS · Quotes · Ramblings · RANDOM

Bravery…

I downloaded a couple of apps for motivational quotes etc. This one popped up today and it instantly sent streams of water down my cheeks. I am brave. I go to bed at night knowing that tomorrow nothing is going to have changed for me. That’s not being pessimistic, it’s being realistic. I go to bed at night, many times, asking whatever entity is out there to please take me home… Wherever that may be. I go to bed at night knowing that there really is nothing of quality there for me when I wake up. And to me, that is bravery. The picture above is one of my most favorites. I never before thought of myself as being brave. I never before thought of myself as being strong. I have always second-guessed everything I have ever done throughout my life. I have never felt good enough for anything or anyone. My only New Year’s resolution (which is pretty new to me as I never make them because I never follow them 😂) is to be unapologetically me. I am no longer going to hide away my feelings of my past, my present, or what my future may hold.

This is definitely going to be a new ride for my blog, a new adventure if you will. I’m scared every night before I go to bed. I’m always scared…

As always, have courage and be kind! 

Fear · Health · HELL · Multiple Sclerosis · Primary Progressive MS · Ramblings · RANDOM

Long time no see…

So many things have happened and I wish I could say for the better. I went through 4 appeals for rehab starting August 18 when I ended up in the hospital. I am now unable to get out of my bed thanks to the pain from the contractures in my hips and thanks to Independence Blue Cross appeals for denying me. The insurance company decided that acute rehab is not medically necessary for me.🖕 Because you know, they’re my doctors! 🤬 I’ll get more into tthat in another blog. Right now I’m just trying to find a way to not go completely mad being completely trapped in a bed. This quote is eerily true. By eerily I mean, that little piece of me… That little girl… Has saved me from leaving this earth by my own hand.

I just wanted to check in and let everyone know that I’m still around. 😜 I am going to try to blog more as I think it will help me from going mad.

When people ask me how I have not gone a little insane from being in my bed, now over six years, I honestly don’t know the answer to that. Quite possibly I have…

Have courage and be kind! 

Health · Multiple Sclerosis · Ramblings

It’s OK to tell your truth

The more I think about what this picture says, the more it’s true. Everyone tells me that you’re so strong you’ll get through this, blah blah blah. What if I’m not that strong. This disease has broken me. And please I don’t want to hear you’ve got to find the positives… I do, I find the positives every day but I can still be broken. And that’s not something to be ashamed of. I’m 55 years old and I am unable to roll over in my bed on my own. I mean really, let that sink in. I’m like a newborn baby. So while I am strong, I’m not made of stone. 

I do feel defeated. And again that doesn’t make me weak! I deal with some things that would break other people. So I get kind of upset when people act like I’m being depressing or I’m acting sad. Yes there are days when it happens. And if that bothers anyone, you know exactly what you can do. 

Last night for the first time in 10 months I had to take a Xanax. I was so ashamed and disappointed in myself. And then I realized that sometimes we have to do what we have to and the medications are there for a reason. And thanks to a wonderful friend of mine, I don’t feel bad about it. When I started trying to pull my hair out I knew it was time. I could feel every lump in my bed. I had to rip my shirt off of me because I felt like I was being strangled. And you have no idea how hard it was. I cannot dress myself, yes read that again I cannot dress myself. So getting my shirt off was a literal fight to the death. Tracy – 1,  T-shirt – 0!!

When I say I am bedridden, I mean that in every sense of the word. I cannot just get up and get into my wheelchair. I need a person and a Hoyer lift. I cannot scratch my foot if it itches. I cannot cross my legs, I can’t move even 5 inches one way or the other on my bed because I cannot move my body by myself. My legs can not hold my body at all if I were to try I would fall directly to the floor. When I start to slide down my bed I can’t pull myself up, my son has to help me with that. What I wouldn’t give to be able to transfer and get in my chair on my own. I would never be in this bed that was a possibility.

When people say, I have MS but it doesn’t have me… I’m sorry but bullshit. The way I feel is, I have MS, and it has me, but I will never give up or give in until my last breath.

I’ve been in a really weird place since my fight with my own body last night. I’m not losing hope, but it something that I’m going to have to think about deal with and move on from. I know it will happen again because it’s not the first time it’s happened. OK I’ll be completely honest, it happens every fucking night but usually cannabis takes care of it.

Please I don’t want the, I’m sorry Tracys or anything like that. I’m just trying to show that MS is not just some little disease. It’s not, just MS.

I really want to spit nails when I see people getting angry because someone tells them they don’t look sick. Trust me be very glad they say that. Because I look sick and it’s obvious that there is something wrong now. Back in the day when someone would tell me that I didn’t look sick, I would look at them and say, you’re right I kick ass because I’m an MS warrior!!  So stop getting mad and let them know what a badass you are!

I’m just tired… October will be six years I’ve been trapped in this bed. I’m really trying to not let that happen, but I have become a realist and while I’m trying and working really hard to get out of this bed, it’s probably gonna take a little longer than that.  And quite frankly, I truly believe I’m going a little mad. I am in prison. The prison, that is my own body and my bedrooms four walls.

And this month on August 19 is the 22nd anniversary of my diagnosis. Oh joy…

As always, have courage and be kind!

 

Anger · Fear · FUCK · Health · HELL · Hope · Love · Multiple Sclerosis · PAIN · Primary Progressive MS · Ramblings · RANDOM

Broken

So this post might be a little long. And you don’t have to read I’m just trying to get out what I’m feeling. We are going to attempt a shower today and I’m already having anxiety. But I have to do it because PTA bed baths are not doing it for me. 😋
I just don’t want to roll over or get in that fucking Hoyer sling. It hurts so much even when I have a nice supply of cannabis on board. 😉
Some of you know I have another fracture in my back at L3 and I was supposed to see a spinal surgeon like last month, but I can’t. I don’t want to go because I don’t want to get up. And the worst part about that is, I really want to get up! I know that does not make any sense. LOL

Without help I don’t know how I’m going to ever be able to get out of this bed. But, I will keep doing what I’m doing like wiggling in the bed LOL I have some serious dance moves for someone who is in bed. 💃🏻 I just want out of it. But when I’m lying down or even when my legs are up and I’m elevated I don’t have any pain. So thankful for my adjustable bed. 🙏🏻 The minute someone moves my legs I literally want to die. It feels like my hip is going to snap and my leg is going to fall right off. Sounds like something out of a criminal minds episode. Childbirth wasn’t as painful. I will take a contraction over this any day. 😳


We rolled a couple of pillows and taped them and put a cover on to jam them on the outside of each leg to roll my hip as I’m lying down. Oh holy man! The first day I could only tolerate about five minutes because the pain was intense. But yesterday I actually kept them there for a few hours. I’m hoping that eventually I will be able to get my legs moving without pain. I don’t care what the doctors say and what my MS is going to do with me because I know if I can get rid of this pain I will be up again. I may never walk again but I will be able to transfer if I can just combat the pain. And thanks to my colostomy and urostomy I won’t have to worry about running to the bathroom every five minutes anymore. 😂 Statistically the odds are against me but I’ve never been a fan of statistics. LOL Do not tell my daughter that because that is what she graduated with honors in. 😜

I’m putting on my little arm weights more because I totally slacked off on doing my arm exercises because depression hit it once again. But my little inner child showed up and beat the crap out of depression. Hopefully it’ll stay away a little longer this time. 🤞
When things got really bad after my surgery in 2014 and I completely fell into a very dark place. The surgery almost took my life and at that time I wished it had. I think a lot of people thought that it was getting to the point where I was nearing the end. I felt it, I even had a doctor tell me my outlook was grim. It wasn’t until February 2018 that I woke up. That anniversary is coming up and it scares me. But it also reminds me that I can fight and can get better. I just want people to know don’t give up on yourself no matter how bad it might be! I have been to the depths of hell and I’ve tried to leave a couple times. For some reason they didn’t want me. LOL

Well now that I’ve written a book and I probably lost most of you after the first paragraph I am going to get myself pumped so I can take my shower and not be afraid. 💪👊

I’ll be back… Said in my best terminator voice. LOL
Have courage and be kind!

Anger · Christmas · Craziness · Fear · Happiness · Health · Hope · Multiple Sclerosis · PAIN · Primary Progressive MS · Ramblings · Sarcasm · Strength

As the year ends…

Most people at this time of year are thinking about their New Year’s resolutions getting ready for all the new things to come. I’m lying here completely lost… I feel like I’m in the twilight zone. This year my house was not decorated for Christmas and it was actually just another day. The holidays are not the same for me anymore because I can no longer get up and get my home decorated and make it feel Christmasy.  I’m telling you the Christmas times when I was better my house was decked the fuck out and looked awesome!  Oh how I miss that!

I’m just void of emotion right now.  Like everyone on the planet none of us knows what tomorrow will bring. Although I do know… It’s just going to bring more of the same of me lying in my bed looking around at my four walls wondering why I’m even here anymore. What is my purpose?  What is the point of life when you can’t live it. I know I’m blessed that I get to wake up every morning… But that’s about it. I wake up and I have a couple choices; watch TV, play on the computer, watch TV, play on the computer…  you get the idea. 😉

I’m not trying to be a Debbie downer I am a realist and quite honestly I hate being a realist. I never was until this piece of shit disease put me in this bed for the past five years. And before that put me in a wheelchair. I’m angry, just like I mentioned in a blog a couple of days ago. I don’t know how to get rid of that anger. I look around and I see a lot. I watch people complain about every day issues like not having enough time in the day to get their kids wherever they need to be or to grocery shop or clean their house. What I wouldn’t give to have those issues. My wish for people is too slow the fuck down and see the beauty around you because quite honestly it could be taken away from you at any moment. A dirty house is a beautiful thing because it means it’s been lived in. And having to run around and take your kids everywhere isn’t a chore it’s a blessing that you are able to do it. I know that I took so many things for granted and I wish I could go back and spend time on certain memories and open my eyes more and be more present. But you cannot go back so please I implore you, be present and if there’s something you want to do do it now. Because one day you may not be able to and I guarantee you will  have so much regret. And trust me, regret is paralyzing!

I’m not sure how much more of a fight I have left in me considering there’s nothing for me to fight with. There are no medications I can take so I just have to pray that my MS will be kind to me and not keep progressing. OK I’m kind of laughing at that last sentence because I am primary progressive so I know that it will keep progressing… I’m just asking it to slow down a little bit. LMAO  I really wish that MS were a person because I would beat the living hell out of it.

I think the worst part about being trapped in a bed is the loneliness. Nobody really wants to sit in your room with you whole are you lying in your bed, even though I’m funny as hell and quite enjoyable to be around. 😂 I really am!  If it weren’t for my beautiful doggies I honestly don’t know if I would still be here. I can’t expect my family  to constantly hang out with mom. They have their own lives. And my husband cannot spend every waking minute in here with me either. Everyone complains that my room is so cluttered and I really should throw things away. I don’t think they understand that this room is my whole life. What they see has junk and clutter are things that make me smile. Stupid things like my living dead dolls or my Lucy collection, my lava lamp, etc. Things that to someone else wouldn’t mean anything but to me they mean everything because they are all that I have! 🖤

So please, for me, do me a favor and instead of making resolutions just make a promise to yourself to be present for every moment that comes your way. It could quite possibly change your life.

Have courage and be kind…

Christmas · Craziness · Fear · FUCK · Health · HELL · Holiday · Medical · Multiple Sclerosis · PAIN · Primary Progressive MS · Ramblings · RANDOM

I’m sorry, but there’s nothing for you…

What do you do when there is nothing for your type of illness? Yes there is a medication now for primary progressive, Ocrevus, but is it really for us. Most of the studies I see have been done on people with relapsing remitting or secondary progressive. They already had medications. LOL what do you do when there’s nothing for you? It’s too dangerous for me to take any of the DMD medications. So how do you live your life knowing nothing, and let’s face it, no one can help you. How do you fight when there are no tools to help you fight? The only way to slow or stop the progression of multiple sclerosis, any type, is to be on one of the disease modifying drugs. So, please, tell me how do I fight? There are people out there that won’t take those medications because they feel the side effects are too dangerous. I would give my right arm to be on one because I can tell you MS will fuck you up a lot more than any of the side effects from the medications. MS is always working in the background and I don’t care how great your diet is or that you exercise 24 hours a day, 😂 that will not slow or stop the progression of multiple sclerosis! So if you are not on one of those medications, I’m so sorry, but you are a special kind of stupid!

I really don’t mean to sound like a bitch, but I have nothing to help me and it angers me. How do you go on with your life knowing that you  can do absolutely nothing to help yourself. Yes I can watch what I eat and shimmey in my bed to keep movement going but that’s not slowing or stopping my progression. I am so fucking angry. I hate the fucking holidays because I cannot physically do anything for anybody not even myself. I don’t know if people really grasp the concept of being bedridden. Someone told me they were bedridden but that they could get in their wheelchair and cruise around whenever they needed to, that they could still transfer and things on their own. 🤯 UMMM  then you’re not fucking bedridden if you can get up all by yourself and get in n out of your wheelchair on your own.  What the actual fuck! I’m so glad I wasn’t near that person because I would’ve seriously opened up a can of whoop ass on them. LMAO when you’re bedridden you can’t get up out of your bed whenever you feel like it. Then you wouldn’t be bedridden! DUH I cannot even sit up on my own. I can’t even roll over on my own. I am stuck lying on my back for however long I stay in this universe. It’s a whole production getting me dressed and out of my bed and that is probably why I don’t do it very often. And it’s very painful… so there you have it.

Yes I’m angry!!

And every now and then you hear of a new celebrity just diagnosed with multiple sclerosis and they make it sound like they are some sort of martyr. For any chronic illness money talks. Granted it sucks that they are also struggling with this illness but they are able to get the resources that the majority of us sorely need but cannot afford.  I would love to have someone at my home helping me every day. Then I could get out of my bed and I could maybe maybe one day get better. I don’t mean get rid of the MS but physically get stronger and mentally having someone to help me could change my life. But unfortunately the majority of us cannot afford Caregivers nor can we afford to handicap accessorize our homes.  So while I feel sad for the celebrity, I would trade places with them in a heartbeat. I don’t even know where I’m going with this blog today. I can just feel that I’m not in a good place so I just needed to get shit out. As always I’ll be OK but sometimes I wonder how I’m going to be OK.

Have courage… And be kind

Fear · FUCK · Health · HELL · Multiple Sclerosis · Primary Progressive MS · Ramblings · RANDOM · Strength

It’s not just MS!!

If anyone ever tells you, be glad it’s just MS!!  Punch them square in the jaw, to hopefully have the end result be that teeth fall out. Then they will remember never to say that to anyone ever again.

I’m really trying to stay positive, but when every day is the same with change nowhere in sight, it can be hard.

I’ll get over this feeling in a little while and I will get back to my positive outlook. But today I’m allowed to  feel this way and be angry.

And no, I’m not glad it was just multiple sclerosis. So next time think before you fucking speak. This is not going out to any one person in general, it’s just something I see all over the Internet when people are ignorant. So now I am going to watch Fast Times at Ridgemont high, laugh at how stupid it is and funny, and find my positive place again.

Have courage and be kind!